Non-Uremic Calciphylaxis: a Rare Diagnosis with Limited Therapeutic Strategies

Calciphylaxis is a rare condition characterized by the emergence of non-healing skin ulcers secondary to arterial calcification and thrombosis, typically diagnosed in patients with end-stage kidney disease (ESKD). When it develops in patients without ESKD, it is called non-uremic calciphylaxis (NUC). The latter is an even rarer diagnosis with an uncertain pathophysiology and a high mortality rate (52%), mainly due to sepsis (50%). Cutaneous biopsy is diagnostic. Therapeutic measures recommended for NUC are limited to wound debridement, analgesia, and control of infection and risk factors. Other therapeutic options exist but with a low level of evidence. We present the case of a 78-year-old woman with NUC in her lower limbs who died of sepsis. NUC is a therapeutic challenge lacking efficient strategies. Learning points: Calciphylaxis in the absence of end-stage kidney disease is called non-uremic calciphylaxis (NUC).This disease is a diagnostic and therapeutic challenge.As therapeutic strategies for NUC mainly derive from those for uremic calciphylaxis, more efficient therapeutic measures and evidence-based recommendations are needed.info:eu-repo/semantics/publishedVersio

Survival of Trojan-Type Companions of Neptune During Primordial Planet Migration

We investigate the survivability of Trojan-type companions of Neptune during primordial radial migration of the giant planets Jupiter, Saturn, Uranus, and Neptune. Loss of Neptune Trojans during planetary migration is not a random diffusion process. Rather, losses occur almost exclusively during discrete episodes when Trojan particles are swept by secondary resonances associated with mean-motion commensurabilities of Uranus with Neptune. The single greatest episode of loss ejects nearly 75% of existing Neptune Trojans and occurs just prior to Neptune reaching its final orbit.Comment: LaTeX file, 26 total pages with 1 table and 11 eps figures. Submitted to Icaru

Knowledge of family health program practitioners in Brazil about sickle cell disease: a descriptive, cross-sectional study

BACKGROUND: Although sickle cell disease is an important public health problem in Brazil, there is a gap in the literature on the level of knowledge of primary health care professionals about the treatment and management of sickle cell disease. Therefore, this study aimed to evaluate the level of knowledge about sickle cell disease of physicians and nurses who work in the Family Health Program in a region of Brazil with a high prevalence of this disease. METHODS: This is a descriptive, cross-sectional study conducted at the municipality of Montes Claros, in the north of Minas Gerais, Brazil. Study participants included 96 physicians and nurses who work at the Family Health Program in an urban area of the city. Data was collected using an original, partially tested questionnaire based on health care check points for children with sickle cell disease established in educational protocols from the State Health Secretary of Minas Gerais and the Ministry of Health. The structured questionnaire contained 47 questions addressing three axes: epidemiology (8 questions); clinical manifestations (13 questions); and management of children with sickle cell disease (26 questions). Knowledge was measured through mean correct responses to proposed questions. Ethical principles were respected and this project was approved by the Committee of Ethics in Research. RESULTS: 59.4% (57) of the study participants were nurses and 40.6% (39) were physicians. The median length of training and median length of service in primary health care were 4.3 (2.8-8.0) years and 4.0 (2.0-7.1) years, respectively. The mean performance in knowledge tests was < 75%, with 5.7/8 (SD = 1.4) for the "epidemiology" questions; 8.6/13 (SD = 2.2) for "clinical manifestations"; and 17.0/26 (SD = 2.9) for "management of children with sickle cell disease" questions; resulting in a mean total of 31.4/47 (SD = 5.10) correct responses. A statistically significant association was found between the number of correct responses and family health care qualifications (p = 0.015). CONCLUSION: There is an urgent need to improve primary health care professional training in the care of children with sickle cell disease

Diagnóstico do estado nutricional do doente oncológico através do IMC, MUST e AGS-GD

Trabalho complementar (Trabalho de Investigação) realizado no âmbito da Unidade Curricular Estágio da Licenciatura em Ciências da Nutrição da Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, sob orientação de Dr.ª Sílvia Pinhão (Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto) e coorientação de Dr.ª Rita Costa Brotas de Carvalho (Hospital do Divino Espírito Santo de Ponta Delgada)Resumo da tese: Introdução: A doença oncológica resulta de uma proliferação celular anormal e é causada por uma interação de fatores alimentares, genéticos e ambientais, representando um enorme problema de saúde pública, sendo responsável por milhões de mortes, por ano, em todo o mundo. Objetivo: Conhecer o estado nutricional do doente oncológico. População e métodos: Estudo transversal de avaliação do estado nutricional de doentes oncológicos que frequentam o Hospital de Dia de Oncologia do Hospital do Divino Espírito Santo de Ponta Delgada, através da aplicação de três ferramentas: IMC, MUST e AGS-GD. Resultados/discussão: A amostra é constituída por 92 doentes, 52 do sexo masculino com idade média de 59 anos e 40 do sexo feminino com idade média de 52 anos. Verificou-se que o IMC não é a ferramenta mais indicada para a avaliação do risco de desnutrição /desnutrição em doentes oncológicos, pois apenas detetou 9,8% dos doentes em risco de desnutrição. Observou-se que o MUST também não é a ferramenta adequada para avaliar este tipo de doentes, uma vez que abrange parâmetros pouco específicos e mal adaptados ao mesmo. No entanto, o MUST conseguiu detetar mais casos de desnutrição do que o IMC (27,2% vs 9.8%). A AGS-GD foi o método que detetou mais casos de doentes desnutridos (55,4%) em comparação com as outras ferramentas. Conclusão: A AGS-GD parece ser o método que melhor traduz a realidade e o estado nutricional do doente oncológico.Thesis abstract: Introduction: The oncologic disease results from abnormal cell proliferation and is caused by an interaction of dietary factors, genetic and environmental, representing a major public health problem, accounting for millions of deaths, per year, worldwide. Objective: Know the nutritional status of the cancer patient. Population/Methods: Cross-sectional study to assess the nutritional status of cancer patients who attend Hospital de Dia de Oncologia of Hospital do Divino Espírito Santo of Ponta Delgada, through the application of three tools: BMI, MUST and AGS-GD. Results/Discussion: The sample is composed of 92 patients, 52 males, mean age 59 years and 40 females with mean age of 52 years. It was found that BMI is not the most appropriate tool for assessing the risk of malnutrition/malnutrition in cancer patients, since only detected 9.8% of patients at risk of malnutrition. It was observed that MUST is not a suitable tool to evaluate this type of patient, since it covers a less specific and maladaptive parameters thereto. However, MUST was able to detect most cases of malnutrition than BMI (27,2% vs 9,8%). The AGS-GD was the method that detected more cases of malnutrition patients (55,4%) compared with the other tools. Conclusion: The AGS-GD seems to be the method that best reflects the reality and the nutritional status of the cancer patient

Scaling in a post-growth era: Learning from Social Agricultural Cooperatives

This is the final version. Available from SAGE Publications via the DOI in this record. It has become normative in organization and management studies literature to consider scaling as a synonym for organizational growth. Scaling is typically understood as scaling-up. This article demonstrates that, in the context of post-growth organizations, scaling involves a more complex set of dynamics. Directing scholarly attention to scaling in the context of Italian Social Agricultural Cooperatives (i.e. organizations that hold a different rationale and modus operandi from the capitalist enterprise), this research contributes to the literature on scaling the impact of post-growth organizations by identifying nine different scaling routes: organizational growth (vertical and horizontal); organizational downscaling; impact on policies; multiplication; impact on organizational culture; impact on societal culture; aggregation; and diffusion. This article demonstrates that post-growth scaling: (1) requires the synergistic interaction of different strategies; (2) focuses on impacting societal culture; (3) does not necessarily require organizational growth; and (4) is a relational process, embedded in socio-ecological systems. The typology presented in this article empowers post-growth organizations to become more aware of different available scaling routes, unlocking their transformative potential and supporting the transition towards a post-growth future, in which the goal of economics is the pursuit of human and ecological flourishing

Assessing the value of a portable near infrared spectroscopy sensor for predicting pork meat quality traits of "asturcelta autochthonous swine breed

Sixty-one intact meat samples from Asturcelta autochthonous swine breed were scanned in the slaughterhouse in reflectance mode. A handheld microelectromechanical system digital transform (Phazir1624, Polychromix Inc.), with a window sampling area of 0.8 × 1 cm and wavelengths ranging from 1,600 to 2,400 nm, was used. With the spectra database recorded were developed different chemometrical models assaying first and second derivatives as math treatment and standard normal variate (SNV) and multiplicative scatter correction for minimizing scattering effect. The greatest predictive capacity was achieved after applying SNV and first derivative for moisture, intramuscular fat (IMF) content, and pH parameters and second derivative for CIE L*, a*, b* colorimetric values, and the Warner-Bratzler force (instrumental texture). The coefficients of determination for calibration ranged from 0.63 to 0.89. The ratio between the standard error of the laboratory and the standard error of calibration ranged from 0.8 to 2.5 for all parameters (1.7 on average) with the exception of b and pH with ratios of 3.5 and 4.1, respectively. The statistical values obtained for the models developed to estimate IMF, CIE L*, a*, b*, moisture, and pH, displayed acceptable predictive capacity. For instrumental texture, the model could be able to discriminate among tender, medium, and hard meat in carcasses for characterization slaughter purposes. © 2013 Springer Science+Business Media New York

Metals and arsenic enrichment processes in sulfide-rich waste dumps - the role of the clay size fraction

[Extract] 1. Purpose Abandoned mines pose some of the most outstanding environmental risks, namely related with potentially toxic metals and metalloids in mining soils. Mobilization or fixation of these elements in the soil particles can be regulated by the interactions between several biogeochemical and mineralogical processes. In this context, the present study is focused on the detection of metals and arsenic enrichment processes in different particle size fractions of two distinctive sulphide-rich waste dumps. Furthermore, the study evaluates the role of typical clay size minerals, such as oxyhydroxides and clay minerals in the retention of toxic elements...info:eu-repo/semantics/publishedVersio

VESTÍGIOS DO CORPO EM UM ROMANCE DE FICÇÃO CIENTÍFICA

Reviewing the relationship among body, culture and language (started in The Semiotics of Passions, 1991), Jacques Fontanille seeks to establish a dialogue between the sensible and the intelligible from a new angle in the French semiotic theory: accepting a biopsychic body as an important entity in the construction of meaning, responsible for uniting expression and meaning, and present in the text as trace of experience, and turned into semiotic object, plane of immanence and content. In the book Corps et Sens (2011), the semiotician interweaves theoretical frameworks built in the human and natural sciences, with semiolinguistic concepts, proposing an approach which relates proprioception, enunciation, figures, sensory fields, body traces and the perception of phenomena, searching for a relationship among body, discourse and semiotic practices. In this article, we intend to demonstrate what this kind of approach can reveal about the literary text. The novel chosen, Do androids dream of electric sheep? (1968), is a famous text by Philip K. Dick, science fiction American author, known mainly for producing dystopic worlds and characters who must always deal with identity issues and their bodies. Revendo a relação entre corpo, cultura e linguagem (iniciada em Sémiotique des Passions, 1991), Jacques Fontanille procura estabelecer, na teoria semiótica francesa, um diálogo entre o sensível e o inteligível, a partir de um novo ângulo: assumindo um corpo biopsíquico como importante entidade na construção do sentido, responsável por unir expressão e conteúdo, e presente no texto como vestígio da experiência, transformado em semiótica-objeto, plano de imanência e figura. No livro Corps et Sens (2011), o semioticista entrelaça arcabouços teóricos oriundos das ciências humanas e naturais, com conceitos de ordem semiolinguística, propondo uma abordagem do sentido que relaciona a propriocepção, a enunciação, a figuração, os campos sensoriais, os vestígios materiais e a percepção de fenômenos, buscando uma relação entre corpo, discurso e práticas semióticas. Nesse artigo, pretende-se demonstrar facetas desse tipo de abordagem em relação ao texto literário. O romance escolhido, Os androides sonham com ovelhas elétricas? (1968), é um famoso texto de Philip K. Dick, autor norte-americano de ficção científica conhecido por produzir mundos distópicos e personagens que estão sempre à volta com questões sobre a identidade e os seus corpos

Abordagens à escrita : do programa de português aos manuais escolares do 2º ciclo do Ensino Básico

Dissertação de Mestrado em Supervisão Pedagógica.Num mundo globalizado, conforme o da sociedade contemporânea, saber utilizar a escrita como instrumento poderoso de comunicação e de intervenção social é uma questão de cidadania. No âmbito de uma perspetiva comunicativa da língua, caberá à escola promover o domínio da escrita, quer como ferramenta de trabalho, quer como forma de intervir socialmente. Este estudo, imbuído num quadro teórico relativo às principais conceções de escrita, numa primeira etapa, procurou apreender as orientações programáticas para o ensino aprendizagem da escrita nos programas de Português do 2.º Ciclo do Ensino Básico (2009) e as conceções de escrita que lhe estão subjacentes. Numa segunda etapa, sob a forma de estudo empírico, foram abordadas as propostas de atividades que tiveram como domínio de referência a produção de textos em doze manuais escolares de 5.º ano de escolaridade, editados no ano de 2011, um instrumento dito de ‘intérprete’ dos programas para alunos e professores. Nestes procurámos identificar os conteúdos programáticos e as conceções da escrita no que refere às produções de texto. Esta investigação empírica seguiu uma metodologia de natureza qualitativa, com recurso à análise de conteúdo. Concluímos que no programa estão implícitas as abordagens cognitiva, sociocultural e comunicativa do ato escritural, onde são valorizadas quer a ação sobre os contextos de produção de texto, quer a ação sobre os processos de escrita. Da análise dos manuais, apuramos que predomina a intenção de escrita que tem como objetivo exprimir experiências, sensibilidades e imaginário, adstrita ao tipo de texto narrativo. Os destinatários dos escritos circunscrevem-se, essencialmente, ao professor e aos alunos da própria turma. Tendencialmente, não se sugere a modalidade de trabalho colaborativo/cooperativo nem o uso do computador como meio de pesquisa da informação, de produção, de revisão e de difusão do texto. No que se refere aos processos de escrita, valoriza-se, nomeadamente, o subprocesso de planificação. Decorrente do nosso estudo, infere-se que é necessário proceder a reajustamentos, quer ao nível dos contextos de produção de escrita, quer ao nível do processo de escrita.ABSTRACT: In nowadays global world, it is an issue of citizenship to know how to use Writing as a powerful tool for communication and social interaction. Within a communicative approach of the language, it’s the aim of the school to promote the Writing Skill, both as a working tool and as a way of interacting in social terms. This essay is framed in a theoretical vision concerning the main writing conceptions and, on a first stage, it tried to seize the guidelines of the program for the teaching and learning of the writing skill in the Portuguese Language Teaching program, for the 5th and 6th grades (2009), and the writing conceptions behind it. On a second stage, in an empirical perspective, the focus was on the proposed activities based on the writing skills, suggested in twelve schoolbooks of the 5th grade, edited in 2011. These books are, for teachers and students, an aid in educational settings and a “so-called” performer of the syllabus. We have tried in them to identify the school syllabus contents and the writing concepts as far as the writing productions are concerned. This empirical research pursued a qualitative methodology using the analyses of contents. In conclusion we can say that in the program the cognitive, social, cultural and communicative approaches are implied in the practicing of writing, in these approaches it is given more importance to the intervention measures, both in the writing production contexts and in the processes of writing. From the analyses of the textbooks, it is evident that the writing intention prevailing is specially to express experiences, sensibilities and imagination, in the narrative text. The addressees of the written texts are, mainly, the teacher and the students of the class. It tends not to give suggestion neither for the collaborative / cooperative work nor for the use of the computer as a mean of searching for information, for production, for revision and for the diffusion of the text. As far as the processes of writing are concerned, enhance is namely on the by-processes of planning. From our essay, one can infer that it is necessary to do some readjustments both on the level of the writing production contexts and on the level of the written procedure