Risk Factors for Bleeding After Gastric Endoscopic Submucosal Dissection: a Systematic Review and Meta-Analysis

BACKGROUND AND AIMS: Postprocedural bleeding (PPB) is the most common adverse event associated with endoscopic resection. Several studies have tried to identify risk factors for PPB after gastric EMR and endoscopic submucosal dissection (ESD), with controversial results. This systematic review and meta-analysis aimed to identify significant risk factors for PPB after gastric EMR and ESD. METHODS: Three online databases were searched. Pooled odds ratio (OR) was computed for each risk factor using a random-effects model, and heterogeneity was assessed by Cochran's Q test and I(2). RESULTS: Seventy-four articles were included. Pooled PPB rate was 5.1% (95% confidence interval, 4.5%-5.7%), which did not vary according to different study designs. Male sex (OR, 1.25), cardiopathy (OR, 1.54), antithrombotic drugs (OR, 1.63), cirrhosis (OR, 1.76), chronic kidney disease (OR, 3.38), tumor size > 20 mm (OR, 2.70), resected specimen size > 30 mm (OR, 2.85), localization in the lesser curvature (OR, 1.74), flat/depressed morphology (OR, 1.43), carcinoma histology (OR, 1.46), and ulceration (OR, 1.64) were identified as significant risk factors for PPB, whereas age, hypertension, submucosal invasion, fibrosis, and localization (upper, middle, or lower third) were not. Procedure duration > 60 minutes (OR, 2.05) and the use of histamine-2 receptor antagonists instead of proton pump inhibitors (OR, 2.13) were the procedural factors associated with PPB, whereas endoscopist experience and preprocedural proton pump inhibitors were not. Second-look endoscopy was not associated with decreased PPB (OR, 1.34; 95% confidence interval, .85-2.12). CONCLUSIONS: Risk factors for PPB were identified that can help to guide management after gastric ESD, namely adjusting further management. Second-look endoscopy is not associated with decreased PPB.info:eu-repo/semantics/publishedVersio

Marital adjustment in the context of female breast cancer: A systematic review

Objective: Breast cancer (BC) diagnosis and subsequent treatments present significant challenges and distress for both patients and their partners. This can lead to difficulties in marital relationships and, consequently, decreases in marital adjustment and psychosocial adaptation to BC for both partners. Our objective was to systematically review studies assessing marital adjustment in the context of female BC to understand which factors are associated with marital adjustment in both patients and partners, and characterize the measures employed to assess marital adjustment within these studies. Methods: This systematic review was conducted in accordance with PRISMA guidelines. English, peer-reviewed articles exploring factors associated with marital adjustment in the context of female BC were considered for inclusion. Results: Fourteen studies were included. Results evidenced that psychosocial variables play an important role on marital adjustment. Specifically, open and constructive communication, more social support, and supportive dyadic coping were found to be associated with higher levels of marital adjustment. Other variables such as self-efficacy, sexual functioning, and psychological adjustment were also positively associated with marital adjustment. Conclusions: Most studies evidenced an association between psychosocial variables and marital adjustment for both women and their partners. Some important dimensions such as communication patterns, coping strategies, and social support dynamics were identified as potential targets for psychological interventions. Some variables, however, were explored only in a few studies which limit our conclusions. Future studies should explore the role these variables and other relational and emotional variables play in promoting marital adjustment after BC

Spatial Analysis of Wildlife Tuberculosis Based on a Serologic Survey Using Dried Blood Spots, Portugal

We investigated the spatial epidemiology of bovine tuberculosis (TB) in wildlife in a multihost system. We surveyed bovine TB in Portugal by serologic analysis of elutes of dried blood spots obtained from hunted wild boar. We modeled spatial disease risk by using areal generalized linear mixed models with conditional autoregressive priors. Antibodies against Mycobaterium bovis were detected in 2.4% (95% CI 1.5%-3.8%) of 678 wild boar in 2 geographic clusters, and the predicted risk fits well with independent reports of M. bovis culture. Results show that elutes are an almost perfect substitute for serum (Cohen unweighted κ = 0.818), indicating that serologic tests coupled with dried blood spots are an effective strategy for large-scale bovine TB surveys, using wild boar as sentinel species. Results also show that bovine TB is an emerging wildlife disease and stress the need to prevent further geographic spread and prevalence increase.Plan Nacional (grant CGL2017-89866 from the Ministry of Economy and Competitiveness, Spain, and Fondo Europeo de Desarollo Regional) and Programa Operacional Regional do Norte (grant ON.2 O Novo Norte), Quadro de Referência Estratégico Nacional through the Fundo Europeu de Desenvolvimento Regional. N.S. was supported by PhD grant SFRH/BD/69390/2010 from Fundação para a Ciência e Tecnologiainfo:eu-repo/semantics/publishedVersio

Serološki dokaz Chlamydia psittaci u papiga u tri zoološka parka u Portugalu

Chlamydia psittaci is an agent that causes ornithosis or psittacosis, which can infect homing and wild birds, mammalian animals and humans. Since this disease is an important zoonosis that is fatal and distributed worldwide, it is important to know its occurrence. This study aimed to survey the seropositivity of Chlamydia psittaci in three psittacine collections in three zoos in Portugal. In this study, 112 blood samples of the psittacine belonging to Order Psitaciformes (encompassing 31 species from 14 genera) were used. These samples were tested using a commercial ELISA kit (Immunocomb®, Biogal). The serological examination of psittacine samples using ELISA showed that 54 were positive (48.2%; 95% confidence interval, CI: 39.0-57.4%). The genus Ara exhibited significantly higher seropositivity than other genera (P<0.05). Based on the serological data from this study, we demonstrate that antibodies against Chlamydia psittaci are circulating in the blood of these tested animals. Since psittacosis is a public health concern, zoonotic issues of these results should be considered.Chlamydia psittaci uzročnik je ornitoze (psitakoze) koja može inficirati i domaće i divlje ptice, sisavce, ali i ljude. S obzirom da je ova bolest sveprisutna zoonoza koja može biti fatalna, a rasprostranjena je diljem svijeta, važno ju je znati prepoznati kada se pojavi. Cilj je ovog rada bio ispitati seropozitivnost na Chlamydia psittaci u tri populacije papiga koje pripadaju trima zoološkim parkovima u Portugalu. U ovoj studiji rabljeno je 112 uzoraka krvi papiga iz reda Psitaciformes (31 različita vrsta iz 14 različitih rodova); uzorci su podvrgnuti komercijalnom ELISA testu (Immunocomb®, Biogal). Serološko ispitivanje uzoraka papiga uporabom ELISA testa pokazalo je da ih je 54 (48,2 %; 95 % interval pouzdanosti, CI: 39,0 %-57,4 %) bilo pozitivno. Rod Ara pokazao je značajno veću seropozitivnost od ostalih rodova (P<0,05). Na temelju seroloških podataka iz ove studije, dokazali smo da protutijela za Chlamydia psittaci cirkuliraju u krvi testiranih životinja. S obzirom da psitakoza predstavlja javnozdravstveni problem, potrebno je razmotriti zoonotska pitanja naših rezultata

Atmospheric trends of CO and CH4 from extreme wildfires in Portugal using sentinel-5P TROPOMI level-2 data

PCIF/GFC/0078/2018 UIDB/00100/2020 UIDB/04085/2020 DL 57/2016Large forest fires have repeatedly affected Europe, in particular the Mediterranean countries. It is now crucial to continue the effort to feed the several layers of prediction models and understand how wildfire spreads in order to develop modern preventative and mitigation methods. The present study evaluates the performance of Sentinel 5-P TROPOMI for the monitoring of carbon monoxide (CO) and methane (CH4) during extreme fire events in Portugal, focusing on the Monchique (2018) and Vila de Rei/Mação (2019) wildfires, which devastated 27,154 ha and 9249 ha, respectively. The spatial distribution and trend of CO and CH4 prior to, during, and following the fire event were accessed and linked with in situ data in a qualitative and quantitative exploration. Large CO plumes were observed with CO columns exceeding 4.5 × 1018 and 6 × 1018 molecules/cm2 on 21 July 2019, and 7 August 2018, respectively. CO distribution profiles after consecutive digital processing steps showed the ability to follow CO fluctuations according to the fire spread. Furthermore, statistically significant differences were found between CO emissions inside and outside the burning area in both fire events. Finally, the CO2 estimated through CO column data presented an emission of 7.6 × 1019 molecules/cm2 for the uppermost emission day on 7 August 2018. Although CH4 monitoring is still unwavering to draw exact conclusions, the CO patterns during extreme fire events show promising and consistent data when compared with in situ data.publishersversionpublishe

Modeling Fine-Scale Cetaceans’ Distributions in Oceanic Islands : Madeira Archipelago as a Case Study

Species distributional estimates are an essential tool to improve and implement effective conservation and management measures. Nevertheless, obtaining accurate distributional estimates remains a challenge in many cases, especially when looking at the marine environment, mainly due to the species mobility and habitat dynamism. Ecosystems surrounding oceanic islands are highly dynamic and constitute a key actor on pelagic habitats, congregating biodiversity in their vicinity. The main objective of this study was to obtain accurate fine-scale spatio-temporal distributional estimates of cetaceans in oceanic islands, such as the Madeira archipelago, using a long-term opportunistically collected dataset. Ecological Niche Models (ENM) were built using cetacean occurrence data collected on-board commercial whale watching activities and environmental data from 2003 to 2018 for 10 species with a diverse range of habitat associations. Models were built using two different datasets of environmental variables with different temporal and spatial resolutions for comparison purposes. State-of-the-art techniques were used to iterate, build and evaluate the MAXENT models constructed. Models built using the long-term opportunistic dataset successfully described distribution patterns throughout the study area for the species considered. Final models were used to produce spatial grids of species average and standard deviation suitability monthly estimates. Results provide the first fine-scale (both in the temporal and spatial dimension) cetacean distributional estimates for the Madeira archipelago and reveal seasonal/annual distributional patterns, thus providing novel insights on species ecology and quantitative data to implement better dynamic management actions.This study was supported by: (i) INTERTAGUA, MAC2/1.1.a/385 funded by MAC INTERREG 2014-2020, (ii) Oceanic Observatory of Madeira throughout the project M142001-0145-FEDER-000001-OOM, and (iii) Fundacao para a Ciencia e Tecnologia (FCT), Portugal, through the strategic project UID/MAR/04292/2020 granted to MARE UI&I. AD and FA have grants funded by ARDITI-Madeira's Regional Agency for the Development of Research, Technology and Innovation, throughout the project M1420-09-5369-FSE000002. RF was partially supported by a FCT doctoral grant (SFRH/BD/147225/2019).info:eu-repo/semantics/publishedVersio

VR open scores: scores as inspiration for VR scenarios

In this paper, we introduce the concept of VR Open Scores: aleatoric score-based virtual scenarios where an aleatoric score is embedded in a virtual environment. This idea builds upon the notion of graphic scores and composed in- strument, and apply them in a new context. Our proposal also explores possible parallels between open meaning in interaction design, and aleatoric score, conceptualized as Open Work by the Italian philosopher Umberto Eco. Our approach has two aims. The first aim is to create an envi- ronment where users can immerse themselves in the visual elements of a score while listening to the corresponding mu- sic. The second aim is to facilitate users to develop a per- sonal relationship with both the system and the score. To achieve those aims, as a practical implementation of our proposed concept, we developed two immersive scenarios: a 360o video and an interactive space. We conclude pre- senting how our design aims were accomplished in the two scenarios, and describing positive and negative elements of our implementations

Influence of water and nutrients on cork oak radial growth – looking for an efficient fertirrigation regime

Abstract The widespread cork oak (Quercus suber L.) mortality and reduced afforestation /regeneration are causing an overall reduction in cork production. To enhance trees’ growth and vitality, afforestation techniques using fertirrigation were tested. The main objective was the promotion of trees’ growth on new dense plantations using minimum water requirements until reaching productive forests. The experimental plot – Irricork – was installed in 2017 in a ≈1 ha stand with 14 years’ age cork oaks summer-fertirrigated since plantation. Four fertirrigation treatments were applied during fertirrigation campaigns. Radial growth, meteorological parameters and fertirrigation volume were measured every 15–30 days over four years. It was observed that weather, tree size, debarking and trees’ intra-competition had a significant effect on radial increments. Fertirrigation significantly enhanced growth during summer drought and decoupled increments from air vapor pressure deficit constraints. There was a linear relationship between trees’ radial increments and fertirrigation volume up to 140 m3 week–1. Above this value, increments were smoother. In conclusion, summer fertirrigation of 140 m3 week–1 efficiently enhanced the radial growth of trees with 50–75 circumference at breast height, under the particular edaphoclimatic conditions of the stand. This study showed to be, therefore, promising in the use of efficient fertirrigation the enhance cork oaks’ radial growth