Testing remotely-sensed predictors of meso-carnivore habitat use in Mediterranean ecosystems

Context: The legacy of human use of Mediterranean ecosystems results in spatial and temporal heterogeneity of resources for wildlife. Understanding wildlife use of these ecosystems may be improved by including information on ecosystem type, structure, and function extracted from remote sensing data. Objectives: To assess whether we can improve our understanding of wildlife-habitat use by including information on ecosystem type, structure and function. Methods: We tested whether remote sensing derived descriptors of ecosystem type, structure (tree cover and patch size) and function (productivity and stress) determine the habitat of stone martens (Martes foina), common genets (Genetta genetta), and European badgers (Meles meles) in southern Portugal. We linked radio-tracking data from five stone martens, five genets and eight badgers with aerial photography, and some spectra-selectivity to classify vegetation, its structure, productivity and drought stress. Results: Statistically-derived generalized linear mixed regression models using combinations of remotely sensed descriptors of ecosystem type, structure and function, performed better than single ecosystem type descriptors. Conclusion: Inclusion of information on ecosystem functioning in predictive models of habitat use is more informative than ecosystem type alone, suggesting functional relationships between wildlife and their habitat. However, inclusion of both ecosystem type and function maybe limited to finer spatial resolutions. Our results illustrate the untapped potential of remote sensing to provide detailed descriptors of habitat at adequate spatial scales, now that they are freely available and are systematically collected over space and time. This information adds useful insights on wildlife-habitat relationships under changing patterns of land use and climate

Correcção de uma má-oclusão de Classe II divisão 1 em duas fases de tratamento

A influência dos aparelhos funcionais no crescimento craniofacial assim como a filosofia dos tratamentos ortodônticos que envolvem duas fases são assuntos controversos. O tratamento das más-oclusões de Classe II Divisão 1 executado em duas fases visa, na primeira fase diminuir a discrepância sagital. A segunda fase pretende obter uma oclusão de acordo com os padrões de oclusão funcional. O objectivo deste artigo consiste em apresentar a sequência de tratamento de um caso clínico de má-oclusão de Classe II Divisão 1, tratado em duas fases, em que foi utilizado um activador do tipo Teuscher, na primeira fase.The influence of functional appliances on craniofacial growth as well as the two-phase orthodontic treatment philosophy are still controversial subjects. The main purpose of the two-phase treatment involving activators is to promote dento-alveolar changes. The goal of the second phase is creating an occlusion according to functional occlusion patterns. The aim of this article is to present the sequence of a Class II Division 1 treatment case in two phases, in which a Teuscher activator is used in the first phase

Complement Decay-Accelerating Factor is a modulator of influenza A virus lung immunopathology

Clearance of viral infections, such as SARS-CoV-2 and influenza A virus (IAV), must be fine-tuned to eliminate the pathogen without causing immunopathology. As such, an aggressive initial innate immune response favors the host in contrast to a detrimental prolonged inflammation. The complement pathway bridges innate and adaptive immune system and contributes to the response by directly clearing pathogens or infected cells, as well as recruiting proinflammatory immune cells and regulating inflammation. However, the impact of modulating complement activation in viral infections is still unclear. In this work, we targeted the complement decay-accelerating factor (DAF/CD55), a surface protein that protects cells from non-specific complement attack, and analyzed its role in IAV infections. We found that DAF modulates IAV infection in vivo, via an interplay with the antigenic viral proteins hemagglutinin (HA) and neuraminidase (NA), in a strain specific manner. Our results reveal that, contrary to what could be expected, DAF potentiates complement activation, increasing the recruitment of neutrophils, monocytes and T cells. We also show that viral NA acts on the heavily sialylated DAF and propose that the NA-dependent DAF removal of sialic acids exacerbates complement activation, leading to lung immunopathology. Remarkably, this mechanism has no impact on viral loads, but rather on the host resilience to infection, and may have direct implications in zoonotic influenza transmissions.This work was funded by Instituto Gulbenkian de Ciência (IGC), Fundac¸ão Calouste Gulbenkian (FCG) and Fundação para a Ciência e a Tecnologia (FCT) (PTDC/IMI-MIC/1142/2012). NBS was funded by Graduate Programme Science for Development (PGCD) and FCG. ZEVS was funded by FCT (SFRH/BD/52179/2013). CG was funded by FCT (POCI-01-0145-FEDER-29780, PTDC/MEDQUI/29780/2017). CAR was funded by FCT (POCI-01-0145-FEDER-007274, UID/BIM/04293). MJA is funded by FCT (2020.02373.CEECIND). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

Sickle cell disease in children: chronic complications and search of predictive factors for adverse outcomes

BACKGROUND: Sickle cell disease (SCD) has extremely variable phenotypes, and several factors have been associated with the severity of the disease. OBJECTIVES: To analyze the chronic complications of SCD and look for predictive risk factors for increased severity and number of complications. METHODS: Retrospective study including all children followed for SCD in the Paediatric Haematology Unit of a tertiary hospital in Portugal, who completed 17 yr old between the years 2004 and 2013. RESULTS: We identified 44 patients, 55% female and 98% black. Chronic complications occurred in 80% of cases. Slight dilatation of the left ventricle was the most frequent complication (47.7%), followed by respiratory function disturbs (43.2%), microlithiasis or cholelithiasis (40.9%), increased flow velocity of cerebral arteries (31.8%), enuresis, delayed puberty and bone abnormalities (6.8% each), sickle cell retinopathy and leg ulcer (4.6% each) and recurrent priapism (2.3%). We identified a statistically significant association between leukocytes >15 000/μL and a higher number of hospitalizations (P < 0.001) and chronic complications of the disease (P = 0.035). The occurrence of dactylitis in first year of life was also significantly associated with a higher number of hospitalizations (P = 0.004) and chronic complications (P = 0.018). The presence of α-thalassemia was associated with a lower number of chronic complications (P = 0.036). CONCLUSIONS: Leucocytosis and dactylitis in the first year of life can be predictors of SCD severity, while the presence of α-thalassemia can be protective. The determination of early predictors of chronic complications of SCD may improve the comprehensive care of these patients

Multiple sclerosis, disease-modifying therapies and COVID-19: A systematic review on immune response and vaccination recommendations

Understanding the risks of COVID-19 in patients with Multiple Sclerosis (MS) receiving disease-modifying therapies (DMTs) and their immune reactions is vital to analyze vaccine response dynamics. A systematic review on COVID-19 course and outcomes in patients receiving different DMTs was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Emerging data on SARS-CoV-2 vaccines was used to elaborate recommendations. Data from 4417 patients suggest that MS per se do not portend a higher risk of severe COVID-19. As for the general population, advanced age, comorbidities, and higher disability significantly impact COVID-19 outcomes. Most DMTs have a negligible influence on COVID-19 incidence and outcome, while for those causing severe lymphopenia and hypogammaglobulinemia, such as anti-CD20 therapies, there might be a tendency of increased hospitalization, worse outcomes and a higher risk of re-infection. Blunted immune responses have been reported for many DMTs, with vaccination implications. Clinical evidence does not support an increased risk of MS relapse or vaccination failure, but vaccination timing needs to be individually tailored. For cladribine and alemtuzumab, it is recommended to wait 3–6 months after the last cycle until vaccination. For the general anti-CD20 therapies, vaccination must be deferred toward the end of the cycle and the next dose administered at least 4–6 weeks after completing vaccination. Serological status after vaccination is highly encouraged. Growing clinical evidence and continuous surveillance are extremely important to continue guiding future treatment strategies and vaccination protocols

Primary Biliary Cholangitis: a Rare Diagnosis During Pregnancy

Primary biliary cholangitis is an autoimmune disease that mostly affects women. It is uncommon in women of childbearing age and the diagnosis during pregnancy is rare and can be challenging. Described here is a case of primary biliary cholangitis first manifesting during pregnancy, with the onset of pruritus, jaundice, biochemical liver abnormalities and positive antimitochondrial antibodies. Although treatment with ursodeoxycholic acid was started at the time of diagnosis, there was a progressive worsening of cholestatic biochemical markers throughout pregnancy. In addition, fasting hyperglycemia with polyhydramnios was diagnosed, consistent with gestational diabetes. She had a spontaneous preterm delivery at 31 weeks of gestation, of a newborn who was admitted to the neonatal intensive care unit but who subsequently had no long-term sequelae of preterm delivery. A maternal postpartum flare occurred. Treatment with ursodeoxycholic acid was well tolerated during pregnancy and lactation.info:eu-repo/semantics/publishedVersio

Vesicovaginal Fistula Associated with Uterine Rupture

Vesicovaginal fistula (VVF) is an obstetric complication rarely reported in developed countries. The occurrence of uterine rupture is a potentially catastrophic event, and its incidence is estimated in 1/1146 (0.07%) pregnancies.The main risk factorsfor its occurrence are: congenital uterine changes, multiparity, history of previous cesarean or myomectomy,fetal macrosomia and induced labor. Association between uterine rupture and bladder lesions has been rarely reported. The authors describe a case of a VVF associated with uterine ruptureinfo:eu-repo/semantics/publishedVersio

Depression Among Portuguese Pregnant Women During Covid-19 Lockdown: A Cross Sectional Study

Introduction: Coronavirus disease 2019 was declared as a pandemic on March 2020. Research on its psychological effects is still lacking. Perinatal depression is a medical complication of pregnancy, especially in situations of stress. In this study, we aimed to investigate the presence of symptoms of depression in pregnant women during the lockdown period in Portugal. Methods: This study consisted in a cross-sectional study among Portuguese pregnant women, who completed an online self-report questionnaire between 25th April and 30th April 2020. An anonymous online questionnaire was developed to assess depression and concerns related to COVID-19. This study was approved by the IRB of Hospital Dona Estefânia and performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. Eligibility criteria included pregnant women, ≥ 18 years and living in Portugal. The primary outcome was to evaluate the presence of depressive symptoms and its association to socio-demographic characteristics and to concerns related to COVID-19. Results: A total of 1698 pregnant women were enrolled. The mean age was 31.9 years. 82.4% felt a negative impact of the pandemic in the surveillance of pregnancy and 43% felt insufficient support. 26.3% showed "possible depression" according to the EPDS. A regression analysis revealed the possibility of depression increased as the concerns about COVID increased and was lower for women with support. The possibility of depression was higher for women with psychiatric medical history. Conclusion: This study demonstrated a significant increase in clinically significant depressive symptoms in pregnant women during the lockdown. It also revealed some of the socio-demographic characteristics of women at risk for depression. If left untreated, depression tends to persist, affecting the woman and also the child. Our findings suggest that COVID-19 represents a serious challenge for this population and reinforce the urgent need for early detection and intervention on mental health issues during pregnancy, especially during the pandemic.info:eu-repo/semantics/publishedVersio

Remote spinal epidural hematoma after spinal anesthesia for caesarean section

In the last few decades there has been a widespread of the use of central neuraxial blockages (CNB) in obstetric patients. The complications from the CNB range from the bothersome to the crippling and life-threatening. Spinal epidural hematoma (SEH) is one of such severe complications. A 29-year-old pregnant woman at term, ASA II, was proposed for a caesarean section after inadequate progression of labour. Spinal anesthesia was administered and surgery was uneventful. The patient recovered from the motor and sensitive blockage but, twelve hours after the procedure, she started complaining of paresthesia over the lower limbs that progressed to paraplegia. An urgent magnetic resonance revealed a dorsally located SEH extending from D7 to D9, remote from the site of needle puncture. The patient was transferred and an emergency laminectomy and evacuation of the hematoma was conducted. One year after the event she remained with neurological deficits.info:eu-repo/semantics/publishedVersio

Care of elderly in Portugal: Official data and scientific and professional challenges

First published online: 10 August 2019The world has never been so active in approaching human needs and human rights. As the population has become older, new kind of pressures has been made over health and protective services, as well as on research targeted to older adults. This chapter presents the scientific and practical developments in the field of elder mistreatment in Portugal. An overview of the scientific trends in Portuguese research is presented. National research on elder mistreatment has been increasing slowly. The current national scenery is focused on prevalence data and identifying risk and vulnerabilities. This chapter will also discuss the support structures available for mistreated older adults in Portugal, namely the current legal framework and the institutions/entities that offer aid to the victims. Legally, elder mistreatment in Portugal is no different from domestic violence, though some legislative advances have been seen in abandonment. Some structures have been developed over the years to offer aid to older adults, from special programs in the police to private institutions, passing by government supported initiatives.This study was conducted at Psychology Research Centre (UID/PSI/01662/2013), University of Minho, and supported by the Portuguese Foundation for Science and Technology and the Portuguese Ministry of Science, Technology and Higher Education through national funds and co-financed by FEDER through COMPETE2020 under the PT2020 Partnership Agreement (POCI-01-0145-FEDER-007653). The first author was funded by a scholarship from the Portuguese Foundations for Science and Technology - FCT - (PD/BD/105965/2014