Synthetic aperture radar (L band) and optical vegetation indices for discriminating the Brazilian savanna physiognomies: A comparative analysis

The all-weather capability, signal independence to the solar illumination angle, and response to 3D vegetation structures are the highlights of active radar systems for natural vegetation mapping and monitoring. However, they may present significant soil background effects. This study addresses a comparative analysis of the performance of L-band synthetic aperture radar (SAR) data and optical vegetation indices (VIs) for discriminating the Brazilian cerrado physiognomies. The study area was the Brasilia National Park, Brazil, one of the test sites of the Large-Scale Biosphere-Atmosphere (LBA) experiment in Amazonia. Seasonal Japanese Earth Resources Satellite-1 (JERS-1) SAR backscatter coefficients (σ°) were compared with two vegetation indices [normalized difference vegetation index (NDVI) and enhanced vegetation index (EVI)] over the five most dominant cerrados' physiognomies plus gallery forest. In contrast to the VIs, σ° from dry and wet seasons did not change significantly, indicating primary response to vegetation structures. Discriminant analysis and analysis of variance (ANOVA) showed an overall higher performance of radar data. However, when both SAR and VIs are combined, the discrimination capability increased significantly, indicating that the fusion of the optical and radar backscatter observations provides overall improved classifications of the cerrado types. In addition, VIs showed good performance for monitoring the cerrado dynamics

Cancer-related knowledge and health status among cancer survivors in Portugal

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Protocolo de insulina em perfusão para controlo intensivo de glicémia em unidades de cuidados intensivos de adultos

Trabalho realizado no contexto do estágio de Cuidados Intensivos do Internato Médico ComplementarEste protocolo destina-se a adultos hiperglicémicos internados numa Unidade de Cuidados Intensivos com suporte nutricional entérico ou parentérico. O protocolo deverá ser interrompido quando o doente inicia alimentação oral. Não se aplica a doentes com emergências diabéticas (cetoacidose diabética e coma hiperosmolar) Recomenda-se determinações frequentes da caliémia (de acordo com indicação médica) Evitar o uso de dextrose para diluição de fármacos. Quando não é possível utilizar água ou SF, utilizar o mínimo volume possível de dextrose Este protocolo aplica-se a doentes que apresentem pelo menos uma determinação de glicemia > 200 mg/dL. O intervalo de glicémia-alvo deste protocolo é 100-139 mg/dL Recomenda-se que este protocolo seja aplicado a doentes cuja previsão de internamento na UCI seja de pelo menos 3 dias. Consultar o médico residente para instruções específicas em caso de: Glicémia ≥ 500 mg/dL Resposta inesperada à infusão de insulina Situações não contempladas no protocol

Controlo intensivo da glicémia em doentes críticos

Trabalho realizado no contexto do estágio de Cuidados Intensivos do Internato Médico ComplementarA evolução da medicina intensiva durante as últimas três a quatro décadas trouxe um aumento tremendo na sobrevivência imediata dos doentes críticos, com patologias previamente letais. É por isso frequente na actualidade que os doentes entrem numa fase crónica de doença crítica, durante a qual permanecem dependentes do suporte de orgãos vitais por um período mais ou menos prolongado. A mortalidade tem permanecido alta entre esse grupo de doentes críticos prolongados, em média cerca de 20% de risco de morte. A falência orgânica múltipla (FOM) é a causa mais frequente de morte, e ocorre independentemente da causa inicial que motivou a admissão na unidade de cuidados intensivos (UCI) 1 . Em termos experimentais, o conceito de alterar a glicémia na doença aguda com o objectivo de modificar o prognóstico foi inicialmente introduzido nos anos 60, com o desenvolvimento de uma infusão de glicose-insulina- potássio (GIK) com potencial terapêutico para os doentes com enfarte agudo do miocárdio (EAM). Múltiplos pequenos estudos de GIK foram completados ao longo dos 30 anos seguintes com resultados conflituosos 2 . No entanto, os estudos que utilizaram a infusão GIK não tiveram como objectivo alcançar ou manter a normalização da glicémia. O primeiro grande estudo aleatorizado de uma infusão glicose-insulina com o objectivo de alcançar a normoglicémia foi o estudo DIGAMI (Diabetes and Insulin-Glucose Infusion in Acute Myocardial Infarction), cujos resultados foram publicados em 1995 3 . O estudo DIGAMI foi o primeiro a fornecer evidência concreta que o controlo glicémico nos doentes hospitalizados podia melhorar os resultados. Por outro lado, estudos não-aleatorizados sobre os efeitos da terapêutica com insulina nas complicações infecciosas de cirurgia cardiotorácica sugeriam o benefício de um controlo mais rigoroso da glicémia do que o habitualmente praticado 2 . Mas até 2001, o interesse no controlo da glicémia em doentes internados em UCI parecia ser bastante baixo. Nesse ano são publicados os resultados daquele que ficaria conhecido como o estudo de Leuven, conduzido por Van den Berghe e colaboradores 4 . A redução relativa da mortalidade observada neste estudo realizado em doentes de uma UCI cirúrgica foi de 42%, uma redução observada com poucas intervenções em cuidados intensivos desde a introdução da ventilação mecânica. Desde essa altura, tem sido dada cada vez mais atenção ao impacto da hiperglicémia na mortalidade dos doentes críticos. Mas se por um lado desde a publicação do estudo de Leuven a terapêutica intensiva com insulina se tornou nalguns países no “standard of care” a alcançar 5,6 , por outro, também nos últimos anos se tem assistido à publicação de estudos com resultados pouco claros e à interrogação cada vez maior sobre os benefícios da generalização do controlo intensivo da glicémia 7,8 . Em 2005 o grupo alemão SepNet suspendeu um ensaio multicêntrico aleatorizado controlado (o estudo VISEP) em doentes médicos e cirúrgicos com sépsis grave após o recrutamento de 488 doentes. O controlo intensivo da glicémia nestes doentes não produziu nenhuma redução na mortalidade e esteve associado uma incidência aumentada de hipoglicémia (12,1% vs. 2,1%) 7

Structure-function correlations in Retinitis Pigmentosa patients with partially preserved vision: a voxel-based morphometry study

Retinitis Pigmentosa is a group of hereditary retinal dystrophy disorders associated with progressive peripheral visual field loss. The impact of this retinal loss in cortical gray matter volume has not been addressed before in Retinitis Pigmentosa patients with low vision. Voxel-based morphometry was applied to study whole brain gray matter volume changes in 27 Retinitis Pigmentosa patients with partially preserved vision and 38 age- and gender-matched normally sighted controls to determine whether peripheral visual loss can lead to changes in gray matter volume. We found significant reductions in gray matter volume that were restricted to the occipital cortex of patients. The anteromedial pattern of reduced gray matter volume in visual primary and association cortices was significantly correlated with the extent of the peripheral visual field deficit in this cohort. Moreover, this pattern was found to be associated with the extent of visual field loss. In summary, we found specific visual cortical gray matter loss in Retinitis Pigmentosa patients associated with their visual function profile. The spatial pattern of gray matter loss is consistent with disuse-driven neuronal atrophy which may have clinical implications for disease management, including prosthetic restoration strategies

Fenómeno de Raynaud com isquémia acral – um caso de crioglobulinémia essencial

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Flexible Blue-Light Fiber Amplifiers to Improve Signal Coverage in Advanced Lighting Communication Systems

Visible-light communication (VLC) based on white light-emitting diodes has recently attracted much attention to provide high-bitrate data communication in indoor environments. One of the remaining challenges to be resolved to enable the proliferation of VLC systems is related to channel attenuation and multiple path fading. Here, we introduce an advanced VLC system integrating an optical amplifier as a promising solution to overcome channel impairments, providing high bitrate coverage. The optical amplifier is a flexible fiber based on a poly(fluorene)-based lumophore doped within a di-ureasil organic-inor- ganic hybrid. Optical amplification is demonstrated for pre-amplifier and relay node scenarios, yielding a maximum gain of 5.9 G 0.2 dB and 3.7 G 0.2 dB, respectively, establishing the proposed approach as a promising cost-effective solution for VLCs. Additionally, numerical simulations show, for a realistic envi- ronment, a 207% improvement in the coverage area, using existing lighting infrastructure without extra cost.R.C.E. acknowledges funding from the European Research Council (ERC) under the European Union’s Ho- rizon 2020 research and innovation programme (grant agreement no. 818762 - SPECTRACON)

Regular physical activity-related awareness and knowledge in Portugal: results from a population-based survey

Background: Previous studies have shown that adequate physical activity (PA, defined as any bodily movement that requires energy expenditure) related awareness and knowledge is crucial to promote regular PA. Therefore, this study aims to characterize PA awareness and knowledge, and to quantify its association with sociodemographic characteristics, health literacy and frequency of exercise. Methods: In a cross-sectional study conducted in 2012, a total of 1624 Portuguese-speaking residents of mainland Portugal (16–79 years old) were assessed through face-to-face interviews using a structured questionnaire. Adjusted prevalence ratios, calculated using Poisson regression, were used to quantify associations with PA awareness and knowledge. Results: The most reported benefits of PA were “reduces abdominal fat accumulation” (95.8%), “reduces myocardial infarction risk” (92.9%) and “improves bone health” (90.7%), these were less referred by older participants, while more often identified by those who exercise daily. The most referred barrier for people to not practice PA regularly was “lack of time” (33.9%) with differences observed by sex, age, education, employment and health literacy. Over two-thirds of participants correctly identified at least 2 of 3 PAs (“running”, “soccer” and “tennis”) that require the most energy, particularly males, those with higher health literacy and who exercise twice or more times a week. Conclusions: An adequate PA-related awareness and knowledge was observed, and differences according to age, health literacy levels and frequency of exercise were found. As such, awareness-raising interventions to increase regular PA through improving physical literacy and motivation should focus on older adults, those with limited health literacy and who do not exercise.Financial support and sponsorship: This study was supported by FEDER funds through Operational Programme Competitiveness and Internationalization and by national funding from The Portuguese Foundation for Science and Technology – FCT (Portuguese Ministry of Education and Science) within the project (HMSPIISE/SAU-ICT/0004/2009) and the Epidemiology Research Unit – Institute of Public Health, University of Porto (EPIUnit; info:eu-repo/grantAgreement/FCT/6817 - DCRRNI ID/UIDB/04750/2020/PT). SM was funded under the scope of the project "NEON-PC - Neuro-oncological complications of prostate cancer: longitudinal study of cognitive decline" (POCI-01-0145-FEDER-032358; Ref. PTDC/SAU-EPI/32358/2017). An individual grant attributed to ARC (SFRH/BD/102181/2014) was co-funded by FCT and the “Programa Operacional Capital Humano” (POCH/FSE). The funding sources had no role in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication

Exclusive Breastfeeding After 40 Years of Age – Where Are We Going?

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