Quaternary fluvial carbonate deposits of the Almonda River Valley, Central Portugal

This paper discusses the formation and preservation of a fluvial tufa system influenced by Atlantic climate based on stratigraphical, chronological (amino-acid racemization, AAR), sedimentological and stable-isotope analyses. On the southwestern Iberian Peninsula, the tufas and associated deposits of the Almonda River valley occur as isolated terraced bodies and reach 25 m thick. AAR dated most deposits to within the warm Marine Isotope Stage 5 (MIS-5). Two Holocene ages were reset within MIS-5 based on diverse criteria. Widely varied carbonate and minor allochthonous coarse detrital facies occur arranged in four simple vertical associations. The deposit geometry and facies association distribution correspond to a low- to moderate-sloped fluvial valley consisting of several short knickpoints and extensive flat areas between them. The latter are occupied by slow-flowing water facies (carbonate sand, lime mud, phytoclast and oncoid rudstones, and up-growing stem boundstones). Facies that formed in moderate- to high-slope substrates were stromatolite, moss and down-growing stem boundstones. The homogeneous Miocene bedrock lithology and gentle structural deformation propitiated this depositional architecture. Calcite δ13C and δ18O values suggest that the aquifer water provided the outflowing Almonda water with (1) 18O-enriched water, compared with present precipitation and groundwater δ18O values, and (2) 13C-depleted CO2 from bituminous rocks and vegetation cover in the catchment. The proximity to the Atlantic coast favoured the Mesozoic-rock aquifer recharge with 18O-enriched water precipitation, assuring water availability during the formation of the studied tufas. No evidence of frequent intense erosion phases might indicate stable precipitation regimes, which would have allowed the preservation of loose fine-grained and palustrine deposits

Juresian riparian birch woodlands: Carici reuterianae-Betuletum celtibericae as. nova.

The Portuguese areas of the Juresian Sector (sensu Rivas-Martínez et al., Itinera Geobotanica, 2002) include a considerable diversity of deciduous woodlands predominated by the Iberian birch (Betula celtiberica). In a recent study of the vegetation of the Peneda-Gerês mountain range (Honrado, Flora e Vegetação do Parque Nacional da Peneda-Gerês, 2003), six different birch-woodland types were recognised and classified according to both dynamic (climactic vs. secondary/ /seral formations) and synecologic (climatophilous vs. edapho-hygrophilous formations) characters. In the same study, riparian birch woodlands of the Juresian Sector were preliminarily described as a new association (Carici reuterianae-Betuletum celtibericae)

PSA and anthropometric measurements among Amazon Indians: an evaluation of the Parkatejê community

OBJECTIVE: PSA (prostate-specific antigen) screening for early detection of prostate cancer in a native community is of great epidemiological importance. The study was conducted with the objective of verifying the occurrence of prostate cancer among members of an Amazon community, as well as its possible relationship to acculturation and overweight (body mass index). METHODS: Lifestyle and anthropometric information was collected from a group of 22 men, presumedly over age 50, members of an isolated community of 363 Amazonian Indians - self-denominated Parkatejê and Kykatêjê - from Pará state, in Northern Brazil. In addition to physical and hematological exams, total and free PSA dosages were performed. RESULTS: Total PSA serum levels ranged from 0.35 to 25.8 ng/ml. Three subjects had PSA levels greater than 4.0 ng/ml, and another two had levels between 2.5 and 4.o ng/ml. Prostate biopsies performed on two subjects indicated the presence of prostate adenocarcinoma in one of them and of intraepithelial neoplasia on the other. Overweight (BMI >25 Kg/m²) and waist-to-hip ratio >0,9 were observed in 68.1% and 72% of subjects, respectively. CONCLUSIONS: Changes in nutritional habits caused by contact with civilization, such as the substitution of more caloric foods for the traditional game and vegetable fiber are increasing the prevalence of overweight among the community. In view of the association between prostate cancer incidence, high-fat diet, and less physical activity, it can be assumed that further cases of prostate neoplasia will occur in the future, since several community members already have high PSA serum levels.OBJETIVO: O rastreamento com o PSA (antígeno prostático específico) para detecção precoce de câncer de próstata em uma comunidade nativa tem grande importância epidemiológica. Assim, realizou-se estudo com objetivo de verificar a ocorrência do câncer da próstata em uma tribo indígena da Amazônia e uma possível relação entre o aculturamento, a presença de sobrepeso (índice de massa corporal) e o aparecimento da doença. MÉTODOS: Foi realizado um levantamento dos hábitos e medidas antropométricas em 22 homens com idade presumida maior de 50 anos, de uma tribo isolada de 363 índios, autodenominados Parkatejê e Kikatêjê, vivendo na região Amazônica (Pará). Além dos exames físico e hematológicos, foram realizadas dosagens de PSA total e PSA livre. RESULTADO: Os níveis séricos de PSA total variaram de 0,35 a 25,8 ng/ml. Três nativos apresentaram PSA maior que 4,0 ng/ml e outros dois evidenciaram PSA entre 2,5 e 4,0 ng/ml. Biopsia prostática em dois nativos revelou a presença de adenocarcinoma de próstata em um e neoplasia intraepitelial em outro. Sobrepeso com índice de massa corporal >25 Kg/m² e relação cintura-quadril >0,9 foram observados em 68,1% e 72,7% do grupo estudado. CONCLUSÕES: Mudanças nutricionais decorrentes do contato com a civilização, como substituição da caça e fibras vegetais por alimentos mais calóricos, estão aumentando a freqüência de sobrepeso na comunidade indígena. Devido à associação entre incidência de câncer de próstata, dieta gordurosa e menor atividade física, pode-se presumir que o futuro testemunhará mais casos da neoplasia prostática, visto que vários de seus membros já evidenciaram altos níveis séricos de PSA.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaUNIFESP, EPMSciEL

Optimal Timing of Delivery among Low-Risk Women with Prior Caesarean Section: A Secondary Analysis of the WHO Multicountry Survey on Maternal and Newborn Health

ObjectiveTo investigate optimal timing of elective repeat caesarean section among low-risk pregnant women with prior caesarean section in a multicountry sample from largely low- and middle-income countries.DesignSecondary analysis of a cross-sectional study.SettingTwenty-nine countries from the World Health Organization Multicountry Survey on Maternal and Newborn Health.Population29,647 women with prior caesarean section and no pregnancy complications in their current pregnancy who delivered a term singleton (live birth and stillbirth) at gestational age 37–41 weeks by pre-labour caesarean section, intra-partum caesarean section, or vaginal birth following spontaneous onset of labour.MethodsWe compared the rate of short-term adverse maternal and newborn outcomes following pre-labour caesarean section at a given gestational age, to those following ongoing pregnancies beyond that gestational age.Main Outcome MeasuresSevere maternal outcomes, neonatal morbidity, and intra-hospital early neonatal mortality.ResultsOdds of neonatal morbidity and intra-hospital early neonatal mortality were 0.48 (95% confidence interval [CI] 0.39–0.60) and 0.31 (95% CI 0.16–0.58) times lower for ongoing pregnancies compared to pre-labour caesarean section at 37 weeks. We did not find any significant change in the risk of severe maternal outcomes between pre-labour caesarean section at a given gestational age and ongoing pregnancies beyond that gestational age.ConclusionsElective repeat caesarean section at 37 weeks had higher risk of neonatal morbidity and mortality compared to ongoing pregnancy, however risks at later gestational ages did not differ between groups

Fabry disease and COVID-19: International expert recommendations for management based on real-world experience

The rapid spread of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 has raised questions about Fabry disease (FD) as an independent risk factor for severe COVID-19 symptoms. Available real-world data on 22 patients from an international group of healthcare providers reveals that most patients with FD experience mild-to-moderate COVID-19 symptoms with an additional complication of Fabry pain crises and transient worsening of kidney function in some cases; however, two patients over the age of 55 years with renal or cardiac disease experienced critical COVID-19 complications. These outcomes support the theory that pre-existent tissue injury and inflammation may predispose patients with more advanced FD to a more severe course of COVID-19, while less advanced FD patients do not appear to be more susceptible than the general population. Given these observed risk factors, it is best to reinforce all recommended safety precautions for individuals with advanced FD. Diagnosis of FD should not preclude providing full therapeutic and organ support as needed for patients with FD and severe or critical COVID-19, although a FD-specific safety profile review should always be conducted prior to initiating COVID-19-specific therapies. Continued specific FD therapy with enzyme replacement therapy, chaperone therapy, dialysis, renin–angiotensin blockers or participation to clinical trials during the pandemic is recommended as FD progression will only increase susceptibility to infection. In order to compile outcome data and inform best practices, an international registry for patients affected by Fabry and infected by COVID-19 should be established

Uma solução automatizada para avaliações quantitativas de impacto: primeiros resultados do MARVIm

Bibliografia: p. 42-44.MARVIm (Automated Model in R for Verification of Impact) was developed as an agile first response tool to eventual demands of impact assessments of interest to BNDES. As a way to showcase the potential of MARVIm, we have implemented a series of assessments to investigate the same issue: how do the different interventions from BNDES affect the short-term performance of clients? Ten different types of intervention were assessed with the microdata from the Annual Social Information Report (Rais) and the Centralized Banking Services S.A. (Serasa) during the years 2008-2011. The variables of interest analyzed were always gross revenues, average number of employees, labor productivity, net profit and investment. In general, there was positive evidence of impact from BNDES on revenue, employment and investment of micro, small and medium-sized companies (MSME) supported with lines for BK acquisition (mainly BNDES Finame) and BNDES Card. Relevant impacts on the net income or labor productivity of clients were not identified. However, the results on the productivity will probably take more than two years to be observed, requiring an analysis interval longer than that implemented herein.O MARVIm (Modelo Automatizado em R para Verificação de Impacto) foi desenvolvido como uma ferramenta de primeira resposta, ágil, a eventuais demandas de avaliações de impacto de interesse do BNDES. Como uma forma de apresentar as potencialidades do MARVIm, implementou-se um conjunto de avaliações com o objetivo de investigar uma mesma questão: como as diferentes intervenções do BNDES impactam no curto prazo a performance das firmas beneficiadas? Dez diferentes tipos de intervenção foram avaliados com o uso de microdados da Relação Anual de Informações Sociais (Rais) e da Centralização de Serviços Bancários S.A. (Serasa) durante os anos de 2008-2011. As variáveis de interesse analisadas foram sempre faturamento bruto, número médio de empregados, produtividade do trabalho, resultado líquido e investimento. De maneira geral, houve evidência positiva de impacto do BNDES sobre o faturamento, o emprego e o investimento das MPMEs apoiadas com linhas para aquisição de BK (fundamentalmente BNDES Finame) e Cartão BNDES. Não foram identificados impactos relevantes sobre o resultado líquido ou a produtividade do trabalho dos beneficiados. Contudo, os resultados sobre a produtividade provavelmente demoram mais do que dois anos para serem sentidos, requerendo um intervalo de análise maior do que o que foi aqui implementado

Prevalence of early initiation of breastfeeding and determinants of delayed initiation of breastfeeding: secondary analysis of the WHO Global Survey

Early initiation of breastfeeding (EIBF) within 1 hour of birth can decrease neonatal death. However, the prevalence of EIBF is approximately 50% in many developing countries, and data remains unavailable for some countries. We conducted a secondary analysis using the WHO Global Survey on Maternal and Perinatal Health to identify factors hampering EIBF. We described the coverage of EIBF among 373 health facilities for singleton neonates for whom breastfeeding was initiated after birth. Maternal and facility characteristics of EIBF were compared to those of breastfeeding >1 hour after birth, and multiple logistic regression analysis was performed. In total, 244,569 singleton live births without severe adverse outcomes were analysed. The EIBF prevalence varied widely among countries and ranged from 17.7% to 98.4% (average, 57.6%). There was less intra-country variation for BFI <24 hours. After adjustment, EIBF was significantly lower among women with complications during pregnancy and caesarean delivery. Globally, EIBF varied considerably across countries. Maternal complications during pregnancy, caesarean delivery and absence of postnatal/neonatal care guidelines at hospitals may affect EIBF. Our findings suggest that to better promote EIBF, special support for breastfeeding promotion is needed for women with complications during pregnancy and those who deliver by caesarean section

Castilla y Portugal en la Edad Media. Relaciones, contactos, influencias (siglos XII-XV)

César Olivera Serrano (Coord.), Instituto de Historia (CSIC).[ES] Los autores de este libro analizan diferentes aspectos de las relaciones luso-castellanas durante la Edad Media: textos, imágenes, procesos históricos, relaciones sociales y culturales. De este modo se ofrece un conjunto de investigaciones que permite comprender mejor la importancia de las relaciones que mantuvieron durante los siglos medievales dos monarquías ibéricas. Junto a los conflictos ocasionales, se desarrollaron numerosos intercambios entre dos sociedades muy semejantes en su fisonomía política, cultural y social.[EN] The authors of this book analyze different aspects of Portuguese-Castilian relations during the Middle Ages: texts, images, historical processes, social and cultural relations. In this way, a set of investigations is offered that allows a better understanding of the importance of the relations that two Iberian monarchies maintained during the medieval centuries. Along with occasional conflicts, numerous exchanges took place between two societies that were very similar in their political, cultural, and social features.Este libro colectivo es parte del proyecto I+D+I PID2020- 114722GB-I00, financiado por MCIN/ AEI/ 10.13039/501100011033.Presentación / César Olivera Serrano (pp. 9-12). -- Textos, crónicas, obras literarias (pp. 13-190). -- Dependencia y emancipación de los diplomas regios portugueses respecto de la tradición leonesa durante el “largo siglo XII”: los preámbulos como ejemplo/ Pablo Martín Prieto (pp. 13-58). -- Imagens cronísticas de Urraca, princesa de Castela e rainha de Portugal / Isabel Barros Dias (pp. 59-84). -- Entre propaganda, memória e história: a problemática da refundição do Livro de Linhagens do conde D. Pedro e os conflitos Luso-Castelhanos de finais do século XIV / João Paulo Martins Ferreira (pp. 85-148). -- Los vínculos de la cultura castellana con las reinas de Portugal (1481-1521) / Isabel Beceiro Pita (pp. 149-168). -- Lidiando con la transgresión: mecanismos de adaptación de la belicosidad episcopal al discurso historiográfico eclesiástico galaicoportugués de los siglos XI-XIV / Iván Curto Adrados (pp. 169-190). -- Reyes y cortesanos (pp. 191-466). -- Una mujer entre reyes: la percepción de María de Portugal fuera de la corte castellana / Ana Arranz Guzmán (191-252). -- Sobre documentos perdidos y amistades peligrosas: Leonor López de Córdoba y Fadrique Enríquez de Castilla y Castro, duque de Arjona / Óscar Perea Rodríguez (pp. 253-284). -- Aproximación a la Casa de un rey “intruso”: el Condestable don Pedro de Portugal en Cataluña, (1464-1466) / Santiago González Sánchez (pp. 285-412). -- Juan de Merlo: un modelo caballeresco portugués en la corte de Juan II de Castilla / César Olivera Serrano (413-466). -- En tierras de frontera (pp. 467-524). -- Los obispos extremeños entre el siglo XIII y XIV: confluencias de intereses y conflictos en un espacio fronterizo / Enrique Asenjo Travesí (pp.467-496). -- Los testamentos del monasterio de Santa María de Oya y su proyección en Portugal / Margarita Cantera Montenegro (pp. 497-524). -- La estética cortesana (pp. 525-572). -- ¿Una reina en la sombra? Arte, política y persuasión al servicio de Juana de Avís (†1475) / María Teresa Chicote Pompanin y Ángel Fuentes Ortiz (pp. 525-572).Peer reviewe

Impact of common cardio-metabolic risk factors on fatal and non-fatal cardiovascular disease in Latin America and the Caribbean: An individual-level pooled analysis of 31 cohort studies

Background: Estimates of the burden of cardio-metabolic risk factors in Latin America and the Caribbean (LAC) rely on relative risks (RRs) from non-LAC countries. Whether these RRs apply to LAC remains unknown. Methods: We pooled LAC cohorts. We estimated RRs per unit of exposure to body mass index (BMI), systolic blood pressure (SBP), fasting plasma glucose (FPG), total cholesterol (TC) and non-HDL cholesterol on fatal (31 cohorts, n=168,287) and non-fatal (13 cohorts, n=27,554) cardiovascular diseases, adjusting for regression dilution bias. We used these RRs and national data on mean risk factor levels to estimate the number of cardiovascular deaths attributable to non-optimal levels of each risk factor. Results: Our RRs for SBP, FPG and TC were like those observed in cohorts conducted in high-income countries; however, for BMI, our RRs were consistently smaller in people below 75 years of age. Across risk factors, we observed smaller RRs among older ages. Non-optimal SBP was responsible for the largest number of attributable cardiovascular deaths ranging from 38 per 100,000 women and 54 men in Peru, to 261 (Dominica, women) and 282 (Guyana, men). For non-HDL cholesterol, the lowest attributable rate was for women in Peru (21) and men in Guatemala (25), and the largest in men (158) and women (142) from Guyana. Interpretation: RRs for BMI from studies conducted in high-income countries may overestimate disease burden metrics in LAC; conversely, RRs for SBP, FPG and TC from LAC cohorts are similar to those estimated from cohorts in high-income countries. Funding: Wellcome Trust (214185/Z/18/Z)Fil: Carrillo Larco, Rodrigo M.. Imperial College London; Reino UnidoFil: Stern, Dalia. Instituto Nacional de Salud Publica (insp);Fil: Hambleton, Ian R.. The University Of The West Indies; BarbadosFil: Hennis, Anselm. Pan American Health Organization; Estados UnidosFil: Cesare, Mariachiara Di. Middlesex University; Reino UnidoFil: Lotufo, Paulo. Universidade de Sao Paulo; BrasilFil: Ferreccio, Catterina. Pontificia Universidad Católica de Chile; ChileFil: Irazola, Vilma. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Perel, Pablo. London School of Hygiene and Tropical Medicine; Reino UnidoFil: Gregg, Edward W. Imperial College London; Reino UnidoFil: Miranda, J. Jaime. Universidad Peruana Cayetano Heredia; PerúFil: Ezzati, Majid. Imperial College London; Reino UnidoFil: Danaei, Goodarz. Harvard Medical School; Estados UnidosFil: Aguilar Salinas, Carlos A.. Instituto Nacional de Ciencias Médicas y Nutrición; MéxicoFil: Alvarez Váz, Ramón. Universidad de la República; UruguayFil: Amadio, Marselle B.. Centro Universitario Senac Santo Amaro; BrasilFil: Baccino, Cecilia. Universidad de la República; UruguayFil: Bambs, Claudia. Pontificia Universidad Católica de Chile; ChileFil: Bastos, João Luiz. Universidade Federal de Santa Catarina; BrasilFil: Beckles, Gloria. Centers for Disease Control and Prevention; Estados UnidosFil: Bernabe Ortiz, Antonio. Universidad Peruana Cayetano Heredia; PerúFil: Bernardo, Carla DO. University of Adelaide; AustraliaFil: Bloch, Katia V.. Universidade Federal do Rio de Janeiro; BrasilFil: Blümel, Juan E.. Universidad de Chile; ChileFil: Boggia, Jose G.. Universidad de la República; UruguayFil: Borges, Pollyanna K.. Universidade Estadual do Ponta Grossa; BrasilFil: Bravo, Miguel. MELISA Institute; ChileFil: Brenes Camacho, Gilbert. Universidad de Costa Rica; Costa RicaFil: Carbajal, Horacio A.. Universidad Nacional de La Plata; ArgentinaFil: Castillo Rascón, María Susana. Universidad Nacional de Misiones; Argentin