Transoesophageal Echocardiography for Monitoring Liver Surgery: Data from a Pilot Study

A pilot study aimed to introduce intraoperative monitoring of liver surgery using transoesophageal echocardiography (TEE) is described. A set of TEE measurements was established as a protocol, consisting of left atrial (LA) dimension at the aortic valve plane; mitral velocity flow integral, calculation of stroke volume and cardiac output (CO); mitral annular plane systolic excursion; finally, right atrial area. A total of 165 measurements (on 21 patients) were performed, 31 occurring during hypotension. The conclusions reached were during acute blood loss LA dimension changed earlier than CVP, and, in one patient, a dynamic left ventricular (LV) obstruction was observed; in 3 patients a transient LV systolic dysfunction was documented. The comparison between 39 CO paired measurements obtained by TEE and PiCCO2 revealed a statistically significant correlation (P < 0.001, r = 0.83). In this pilot study TEE successfully answered the questions raised by the anesthesiologists. Larger cohort studies are needed to address this issue

Relatório de Estágio de Inês Filipe Pissarra Correia Pinto Varela

O presente documento insere-se no âmbito da Unidade Curricular de Prática Educativa Supervisionada, surgindo com um culminar do percurso formativo de formação inicial, vivenciado nos contextos de Educação Pré-Escolar e 1.º Ciclo do Ensino Básico. Destarte, visa refletir as competências e aprendizagens adquiridas, resultantes da articulação entre os conhecimentos científicos, pedagógicos e didáticos, os documentos orientadores e a ação educativa desempenhada. Por conseguinte, urge destacar que a importância atribuída a este processo de articulação, possibilitou o desenvolvimento de práticas pedagógicas refletidas a partir de uma observação e reflexão contínua dos contextos educativos, através de grelhas de observação e do diário de formação. Assim, potencializou uma análise das ações desenvolvidas de forma mais crítica e analítica, originando uma ação contextualizada, numa perspetiva de constante atualização e construção da identidade profissional, enquanto futura docente de perfil duplo. Importa salientar que todas as práticas implementadas foram desenvolvidas em torno da abordagem cíclica e dinâmica da metodologia de investigação-ação. O presente relatório espelha o trabalho colaborativo desenvolvido entre a díade, as docentes cooperantes, as crianças e alunos dos dois contextos e as supervisoras institucionais, alvitrando no sentido da implementação de práticas inovadoras e diferenciadas.This report is part of the Curricular Unit of Supervised Educational Practice, resulting from the initial training path, experienced in the contexts of Pre-School Education and 1st Cycle of Basic Education. Thus, it seeks to mirror the skills and learning acquired, resulting from the articulation between scientific and didactic knowledge, normative documents and the educational action performed. Consequently, it is important to highlight that it was the articulation process that enabled the development of pedagogic practices through a continuous observation and reflection of the educative contexts, using tools such as daily observation grids and training diaries. This method has allowed a critical analysis of the developed actions, contextualizing them in the setting of continuous improvement and construction of the professional identity, consistent with the profile of a future multifaceted teacher. It should be noted that all the implemented practices were developed with the cyclic approach and the investigationaction methodology in mind. This document translates the collaborative work developed between the dyad, the cooperative teachers, the children, and the institutional supervisors, advocating the development of innovative and differentiated practices

Proposta metodológica de Pagamentos por Serviços Ambientais (PSA) visando a produção de água limpa em mananciais

The Payment for Environmental Services (PES) instrument aims to quantify an Ecosystem Service (ES), so that its production is valued and based on a socioeconomic financial system for conservation. The land use on the terrain and the environmental attributes of a watershed directly interfere in the capacity to store water in the system of a functional unit and can be transformed into an Environmental Service. The proposed methodology aims to determine environmental indicators that can support the valuation of the production of water of better quality. The environmental attributes of geology, soil, slope and land use land cover are measured and analyzed. The zoning of the most vulnerable rural areas was determined for possible implementation of PES programs and valuation of spring water in proportion to the contribution of their water production area in the sub-basin. The methodology has proven to be efficient in determining the most environmentally vulnerable areas, in order to classify water production by sub-basins, and it suggests a market form for financing ecosystem conservation that considers the principles of the provider-receiver (which contribute to the generation of environmental service –water and soil quality) and user-payer (who benefit from and pay for it). The financial incentive to rural producers in watershed areas is only provided when management and conservation practices are carried out through activities of plant and animal production on a sustainable land use.O instrumento de Pagamento por Serviço Ambiental (PSA) visa quantificar um Serviço Ecossistêmico (SE) de forma que sua produção seja valorada e baseada em um sistema financeiro socioeconômico da conservação. O uso do solo nas vertentes e os atributos ambientais de uma bacia hidrográfica interferem diretamente na capacidade de armazenar água no sistema de uma unidade funcional e podem ser transformados em Serviço Ambiental (SA). A metodologia proposta tem como objetivo determinar indicadores ambientais que possam dar suporte a valoração da produção de água de melhor qualidade. Os atributos ambientais geologia, solo, declividade e cobertura do solo são mensurados e analisados. O zoneamento das áreas rurais mais vulneráveis foi determinado para possível valoração da água de manancial de forma proporcional a contribuição da sua área de produção de água na sub-bacia e para a implementação dos programas de PSA. A metodologia se demonstrou eficiente para determinar as áreas mais vulneráveis ambientalmente, de forma a classificar as áreas ambientalmente mais vulneráveis e na produção de água por subbacias. O processo é passível de se tornar uma forma de mercado da água para financiamento da conservação do ecossistema que considera os princípios do provedor-recebedor (que contribuem para a geração do SA – água e solo de qualidade) e usuário-pagador (que se beneficiam e pagam o SA). O incentivo financeiro ao produtor rural de áreas de manancial deve ser realizado somente quando ocorrem práticas de manejo e conservação por meio de atividades de produção vegetal e animal de uso do solo sustentável

Tratamento endovascular de doença oclusiva aorto-ilíaca: estudo retrospectivo

Objetivos: Avaliar os resultados técnicos do tratamento endovascular em lesões oclusivas do sector aorto-ilíaco.Material e métodos: Foi efectuada uma análise retrospectiva entre Janeiro de 2008 e Janeiro de 2016 de todos os procedimentos endovasculares realizados num único centro para tratamento de lesões ateroscleróticas aorto-ilíacas. Foram avaliados os tipos de lesões existentes, os procedimentos endovasculares utilizados, as taxas de sucesso técnico e de complicações.Resultados: Foram estudados retrospectivamente 194 doentes (idade média 67,44 anos, DP=10,29; 91% sexo masculino). O tipo de lesão mais frequente foi estenose das artérias ilíacas comuns. A colocação de kissing stents foi a técnica mais utilizada (n=96; 49,5%), seguida da colocação de stent ilíaco único (n=85; 43,8%) e angioplastia com balão isolada (n=8; 4,1%). Em cinco casos (2,6%) não foi possível ultrapassar a lesão oclusiva. Verificaram-se complicações imediatas em 5,2% (n=10), sendo a ocorrência de laceração arterial a complicação mais comum, tendo-se registado casos isolados de migração do stent, hematoma e embolização para a artéria femoral superficial. A taxa de sucesso técnico imediato foi de 96,9%.Conclusões: O tratamento endovascular de lesões estenosantes/oclusivas do sector aorto-ilíaco é tecnicamente eficaz na esmagadora maioria dos doentes, com baixas taxas de complicações associadas

Heritage and the Sea: Maritime History and Archaeology of the Global Iberian World (15th -18th centuries)

This two-volume set highlights the importance of Iberian shipbuilding in the centuries of the so-called first globalization (15th to 18th), in confluence with an unprecedented extension of ocean navigation and seafaring and a greater demand for natural resources (especially timber), mostly oak (Quercus spp.) and Pine (Pinus spp.). The chapters are framed in a multidisciplinary and interdisciplinary line of research that integrates history, Geographic Information Sciences, underwater archaeology, dendrochronology and wood provenance techniques. This line of research was developed during the ForSEAdiscovery project, which had a great impact in the academic and scientific world and brought together experts from Europe and America. The volumes deliver a state-of-the-art review of the latest lines of research related to Iberian maritime history and archaeology and their developing interdisciplinary interaction with dendroarchaeology. This synthesis combines an analysis of historical sources, the systematic study of wreck-remains and material culture related to Iberian seafaring from the 15th to the 18th centuries, and the application of earth sciences, including dendrochronology. The set can be used as a manual or work guide for experts and students, and will also be an interesting read for non-experts interested in the subject.Volume 1 focuses on the history and archaeology of seafaring and shipbuilding in the Iberian early modern world, complemented by case studies on timber trade and supply for shipbuilding, analysis of shipbuilding treatises, and the application of Geographic Information Systems and Databases (GIS) to the study of shipwrecks.Volume 2 focuses on approaches to the study of shipwrecks including a synthesis of dendro-archaeological results, current interdisciplinary case studies and the specialist study of artillery and anchors.Peer reviewe

Diagnosis on Transport Risk Based on a Combined Assessment of Road Accidents and Watershed Vulnerability to Spills of Hazardous Substances

Roads play an important role in the economic development of cities and regions, but the transport of cargo along highways may represent a serious environmental problem because a large portion of transported goods is composed of dangerous products. In this context, the development and validation of risk management tools becomes extremely important to support the decision-making of people and agencies responsible for the management of road enterprises. In the present study, a method for determination of environmental vulnerability to road spills of hazardous substances is coupled with accident occurrence data in a highway, with the purpose to achieve a diagnosis on soil and water contamination risk and propose prevention measures and emergency alerts. The data on accident occurrences involving hazardous and potentially harmful products refer to the highway BR 050, namely the segment between the Brazilian municipalities of Uberaba and Uberl&acirc;ndia. The results show that many accidents occurred where vulnerability is high, especially in the southern sector of the segment, justifying the implementation of prevention and alert systems. The coupling of vulnerability and road accident data in a geographic information system proved efficient in the preparation of quick risk management maps, which are essential for alert systems and immediate environmental protection. Overall, the present study contributes with an example on how the management of risk can be conducted in practice when the transport of dangerous substances along roads is the focus problem

The Configuration of Forest Cover in Ribeirão Preto: A Diagnosis of Brazil’s Forest Code Implementation

The fragmentation of forests is a consequence of human activities that intensively change the natural landscapes. In Brazil, there is a long-standing legal framework for native vegetation protection, called Forest Code. The last update is from 2012. The revisions incorporated in this restructured code (Law No. 12,651/12) encompassed new rules, rights and obligations for adequate land use management of productive systems and for environmental conservation and protection. An example of a protective measure was the creation of a Legal Reserve inside the rural properties and Areas of Permanent Protection around the watercourses. This study explored the effects of implementing the new code on the spatial and temporal evolution of forest cover fragmentation since the legal changes were set up. In that context, the area, perimeter and shape (circularity index) of forest fragments, as well as the buffer strips along watercourses, were assessed from 2010 to 2016 within the municipality of Ribeir&atilde;o Preto, S&atilde;o Paulo state, Brazil. The assessment resorted to remote sensing techniques and visual inspection of orbital images. It was clear from the results that forest patches became more abundant but smaller, more dispersed and elongated, and that this route to fragmentation was hinged on a chaotic expansion of urban and agricultural areas. Important edge effects were anticipated from these results. The area numbers revealed that Ribeir&atilde;o Preto was 7.95% covered with forest fragments in 2010, while this percentage rose to 8.03% in 2013 and reached 8.35% in 2016. Most of this increase occurred within a 30-meter wide buffer along the watercourses. This was a positive outcome. However, the numbers also revealed that forested areas smaller than 51 hectares increased from 71% in 2010 to 73% in 2016. The conclusions were that implementation of Law No. 12,651/12 is leading to an increase of forestland, but not yet promoting sustainability, namely through improved connectivity among fragments for reduction of edge effects and provision ecosystem services

Potential Impacts of Land Use Changes on Water Resources in a Tropical Headwater Catchment

The main objective of this study was to investigate the relationships between land use and future scenarios of land changes on water runoff and groundwater storage in an Environmental Protection Area (EPAs) watershed. The methodology was based on the application of the Soil and Water Assessment Tool (SWAT) hydrological modelling to investigate flow simulations in current land use and in two future scenarios (forest and pasture). The performance of goodness-of-fit indicators in the calibration (NSE = 0.82, R2 = 0.85, PBIAS = 11.9% and RSR = 0.42) and validation (NSE = 0.70, R2 = 0.72, PBIAS = −4% and RSR = 0.55) was classified as good and very good, respectively. The model accurately reproduced the inter-annual distribution of rainfall. The spatial distribution of average annual surface flow, lateral flow, and groundwater flow were different between sub-basins. The future scenario on land use change to forest (FRSE) and pasture (PAST) differed during the year, with greater changes on rainy and dry seasons. FRSE increase of 64.5% in area led to decreased surface runoff, total runoff, and soil water; and increased lateral flow, groundwater, and evapotranspiration. The effect of the natural vegetation cover on soil moisture content is still unclear. The hydrological model indicated the main areas of optimal spatial water flow. Considering economic values, those areas should encourage the development of government policies based on incentive platforms that can improve environmental soil and water sustainability by establishing payment for environmental services (PES)

A Regression Model of Stream Water Quality Based on Interactions between Landscape Composition and Riparian Buffer Width in Small Catchments

Riparian vegetation represents a protective barrier between human activities installed in catchments and capable of generating and exporting large amounts of contaminants, and stream water that is expected to keep quality overtime. This study explored the combined effect of landscape composition and buffer strip width (L) on stream water quality. The landscape composition was assessed by the forest (F) to agriculture (A) ratio (F/A), and the water quality by an index (IWQ) expressed as a function of physico-chemical parameters. The combined effect (F/A &times; L) was quantified by a multiple regression model with an interaction term. The study was carried out in eight catchments of Uberaba River Basin Environmental Protection Area, located in the state of Minas Gerais, Brazil, and characterized by very different F/A and L values. The results related to improved water quality (larger IWQ values) with increasing values of F/A and L, which were not surprising given the abundant similar reports widespread in the scientific literature. But the effect of F/A &times; L on IWQ was enlightening. The interaction between F/A and L reduced the range of L values required to sustain IWQ at a fair level by some 40%, which is remarkable. The interaction was related to the spatial distribution of infiltration capacity within the studied catchments. The high F/A catchments should comprise a larger number of infiltration patches, allowing a dominance of subsurface flow widespread within the soil layer, a condition that improves the probability of soil water to cross and interact with a buffer strip before reaching the stream. Conversely, the low F/A catchments are prone to the generation of an overland flow network, because the absence of permanent vegetation substantially reduces the number of infiltration patches. The overland flow network channelizes runoff and conveys the surface water into specific confluence points within the stream, reducing or even hampering an interaction with a buffer strip. Notwithstanding the interaction, the calculated L ranges (45&ndash;175 m) are much larger than the maximum width imposed by the Brazilian Forest Code (30 m), a result that deserves reflection

Causality among landscape characteristics, seasonality and stream water quality in the Paraopeba river basin

Anthropogenic pressures on the environment are increasingly evident, characterized by uncontrolled changes in land use that adversely affect water quality. This study aims to assess how land use and land cover contribute to water quality and to evaluate the influence of spatial landscape metrics on water quality variability in eight tributary sub-basins of the Paraopeba River. The analysis considers two seasonal periods reflective of the region's tropical climate. The dataset includes spatial data on land use and land cover, digital elevation models, soil types, geology, geomorphology, spatial-temporal data, and landscape fragmentation metrics. First, spatial differences in water quality data collected at each sampling site were tested, and the significance of seasonal variations was assessed. Correlation analyses were then conducted to determine the relationships between landscape metrics and water quality parameters across the eight sub-basins, considering both seasonal periods. Key findings include the identification of mixed pollution sources, such as pasture, urban areas, and mining, which significantly affect water quality, particularly during the rainy period. Conversely, forest plantations were found to be the land use category that most positively contributed to the preservation of water quality. The relationships between landscape patterns and water quality, analyzed using redundancy analysis, revealed that the influence of landscape metrics on the variation of water quality parameters was significantly more pronounced during the dry period, explaining 75 % of the variation, compared to 49 % during the rainy period