Models to Implement a Sustainable Forest Management - An Overview of the ModisPinaster Model

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Crossroad between Inflammation, Iron and Lipids in Atherogenesis

Atherosclerosis (ATH) is recognized as a chronic inflammatory condition and it is the leading cause of cardiovascular disease. The process of atherogenesis is characterized by the accumulation and oxidation of LDL (oxLDL) in the vessel wall and subsequent infiltration and activation of immune cells, particularly monocytes in an earlier stage and, later on, lymphocytes. The infiltrated monocytes differentiate into macrophages which then could differentiate into foam cells as a consequence of oxLDL uptake [1]. The recruitment of immune cells to the site of ATH lesion contributes to a local pro-inflammatory state that will promote the development of the atheroma plaque and progression of the disease. However, the exact mechanisms involved in this process are not fully understood. One hypothesis is the contribution of oxidative stress mediated by metals such as iron [2]. Previous authors have shown high iron content in foam cells and also accumulation of hemoglobin and ferritin in the areas rich in foam cells [3]. Herein, we investigate a possible mechanism for cellular iron accumulation by testing the effect of pro-inflammatory as well as pro-atherogenic stimuli in the expression of proteins involved in iron efflux in macrophages.This work was supported by National Institute of Health Doutor Ricardo Jorge, I.P, INSERM (Institut National de la Santé et de la Recherche Médicale), CNRS (Centre National de la Recherche Scientifique), ANR (Agence Nationale de la Recherche, France; ANR- 08- GENO-000) , Fundação para a Ciência e Tecnologia (Grant SFRH/BD/48671/2008) and BioFIG (Center for Biodiversity, Functional and Integrative Genomics)

Tourism and Sustainability: resumption after COVID-19

Experience tourism in the midst of nature, the appreciation of healthy food, which allows to appreciate, taste and experience the moment becomes the motto for the beginning of a new era. The objective of this study was to identify which actions are necessary to internalize the SDGs in the resumption of tourism activities after the pandemic. The analysis of the perceptions of public managers, private initiative, and educational institutions to understand and awaken the issues of sustainability in environmental issues, in the resumption of tourism with a demand for activities in the midst of nature. The methodology was exploratory explanatory, of qualitative analysis, and uses content analysis, the NVivo11 software was used for transcription of the videos and description of the speeches of the speakers who participated in the extension activity three webinars held in 2021, within the extension project entitled "Tourism and Sustainability - a conscious resumption", proposed by the Research Group on Policies, Public Management and Development of UERGS/CNPq. He concluded that the speakers representing both educational institutions and public and private management emphasized in their speeches that: a) tourism, b) research, c) sustainability, and d) gastronomy are currently inseparable themes. Finally, the uncertainty of the future to reassess and plan the issues of environmental, economic and social sustainability, both in the resumption and how to adhere to the SDGs in a conscious and possible to do

Automated Quantitative Pupillometry for the Prognostication of Coma After Cardiac Arrest

Background: Sedation and therapeutic hypothermia (TH) delay neurological responses and might reduce the accuracy of clinical examination to predict outcome after cardiac arrest (CA). We examined the accuracy of quantitative pupillary light reactivity (PLR), using an automated infrared pupillometry, to predict outcome of post-CA coma in comparison to standard PLR, EEG, and somato-sensory evoked potentials (SSEP). Methods: We prospectively studied over a 1-year period (June 2012-June 2013) 50 consecutive comatose CA patients treated with TH (33°C, 24h). Quantitative PLR (expressed as the % of pupillary response to a calibrated light stimulus) and standard PLR were measured at day 1 (TH and sedation; on average 16h after CA) and day 2 (normothermia, off sedation: on average 46h after CA). Neurological outcome was assessed at 90days with Cerebral Performance Categories (CPC), dichotomized as good (CPC 1-2) versus poor (CPC 3-5). Predictive performance was analyzed using area under the ROC curves (AUC). Results: Patients with good outcome [n=23 (46%)] had higher quantitative PLR than those with poor outcome [n=27; 16 (range 9-23) vs. 10 (1-30)% at day 1, and 20 (13-39) vs. 11 (1-55)% at day 2, both p0.20). Conclusions: Quantitative PLR is more accurate than standard PLR in predicting outcome of post-anoxic coma, irrespective of temperature and sedation, and has comparable prognostic accuracy than EEG and SSEP

Benchmarks in Liver Resection for Intrahepatic Cholangiocarcinoma

Introduction: Benchmarking in surgery has been proposed as a means to compare results across institutions to establish best practices. We sought to define benchmark values for hepatectomy for intrahepatic cholangiocarcinoma (ICC) across an international population. Methods: Patients who underwent liver resection for ICC between 1990 and 2020 were identified from an international database, including 14 Eastern and Western institutions. Patients operated on at high-volume centers who had no preoperative jaundice, ASA class &lt;3, body mass index &lt;35 km/m2, without need for bile duct or vascular resection were chosen as the benchmark group. Results: Among 1193 patients who underwent curative-intent hepatectomy for ICC, 600 (50.3%) were included in the benchmark group. Among benchmark patients, median age was 58.0 years (interquartile range [IQR] 49.0–67.0), only 28 (4.7%) patients received neoadjuvant therapy, and most patients had a minor resection (n = 499, 83.2%). Benchmark values included ≥3 lymph nodes retrieved when lymphadenectomy was performed, blood loss ≤600 mL, perioperative blood transfusion rate ≤42.9%, and operative time ≤339 min. The postoperative benchmark values included TOO achievement ≥59.3%, positive resection margin ≤27.5%, 30-day readmission ≤3.6%, Clavien-Dindo III or more complications ≤14.3%, and 90-day mortality ≤4.8%, as well as hospital stay ≤14 days. Conclusions: Benchmark cutoffs targeting short-term perioperative outcomes can help to facilitate comparisons across hospitals performing liver resection for ICC, assess inter-institutional variation, and identify the highest-performing centers to improve surgical and oncologic outcomes.</p

Benchmarks in Liver Resection for Intrahepatic Cholangiocarcinoma

Introduction: Benchmarking in surgery has been proposed as a means to compare results across institutions to establish best practices. We sought to define benchmark values for hepatectomy for intrahepatic cholangiocarcinoma (ICC) across an international population. Methods: Patients who underwent liver resection for ICC between 1990 and 2020 were identified from an international database, including 14 Eastern and Western institutions. Patients operated on at high-volume centers who had no preoperative jaundice, ASA class &lt;3, body mass index &lt;35 km/m2, without need for bile duct or vascular resection were chosen as the benchmark group. Results: Among 1193 patients who underwent curative-intent hepatectomy for ICC, 600 (50.3%) were included in the benchmark group. Among benchmark patients, median age was 58.0 years (interquartile range [IQR] 49.0–67.0), only 28 (4.7%) patients received neoadjuvant therapy, and most patients had a minor resection (n = 499, 83.2%). Benchmark values included ≥3 lymph nodes retrieved when lymphadenectomy was performed, blood loss ≤600 mL, perioperative blood transfusion rate ≤42.9%, and operative time ≤339 min. The postoperative benchmark values included TOO achievement ≥59.3%, positive resection margin ≤27.5%, 30-day readmission ≤3.6%, Clavien-Dindo III or more complications ≤14.3%, and 90-day mortality ≤4.8%, as well as hospital stay ≤14 days. Conclusions: Benchmark cutoffs targeting short-term perioperative outcomes can help to facilitate comparisons across hospitals performing liver resection for ICC, assess inter-institutional variation, and identify the highest-performing centers to improve surgical and oncologic outcomes.</p