Reptile responses to fire across the western Mediterranean Basin.

Effects of anthropogenic activities, including climate change, are modifying fire regimes, and the dynamic nature of these modifications requires identification of general patterns of organisms' responses to fire. This is a challenging task because of the high complexity of factors involved (including climate, geography, land use, and species-specific ecology). We aimed to describe the responses of the reptile community to fire across a range of environmental and fire-history conditions in the western Mediterranean Basin. We sampled 8 sites that spanned 4 Mediterranean countries. We recorded 6064 reptile sightings of 36 species in 1620 transects and modeled 3 community metrics (total number of individuals, species richness, and Shannon diversity) as responses to environmental and fire-history variables. Reptile community composition was also analyzed. Habitat type (natural vs. afforestation), fire age class (time since the last fire), rainfall, and temperature were important factors in explaining these metrics. The total number of individuals varied according to fire age class, reaching a peak at 15-40 years after the last fire. Species richness and Shannon diversity were more stable during postfire years. The 3 community metrics were higher under postfire conditions than in unburned forest plots. This pattern was particularly prevalent in afforested plots, indicating that the negative effect of fire on reptiles was lower than the negative effect of afforestation. Community composition varied by fire age class, indicating the existence of early- and late-successional species (xeric and saxicolous vs. mesic reptiles, respectively). Species richness was 46% higher in areas with a single fire age class relative to those with a mixture of fire age classes, which indicates pyrodiverse landscapes promoted reptile diversity. An expected shift to more frequent fires will bias fire age distribution toward a predominance of early stages, and this will be harmful to reptile communities.

Respuestas de reptiles al fuego en la Cuenca Mediterránea occidental Resumen Los efectos de actividades antropogénicas, incluyendo el cambio climático, están modificando los regímenes de fuego, y la naturaleza dinámica de estas modificaciones requiere la identificación de patrones generales de las respuestas de los organismos al fuego. Esta es una tarea desafiante debido a la gran complejidad de los factores involucrados (incluyendo clima, geografía, uso de suelo y la ecología de cada especie). Nuestro objetivo fue describir las respuestas de la comunidad de reptiles al fuego bajo diversas condiciones ambientales e historias de fuego en la Cuenca Mediterránea occidental. Muestreamos ocho sitios en cuatro países mediterráneos. Registramos 6064 avistamientos de reptiles de 36 especies en 1620 transectos y modelamos tres métricas comunitarias (número total de individuos, riqueza de especies y diversidad de Shannon) como respuestas a las variables ambientales y de historia de fuego. También analizamos la composición de la comunidad de reptiles. El tipo de hábitat (natural versus forestación), la clase de edad del fuego (tiempo transcurrido desde el último incendio), la precipitación pluvial y la temperatura fueron factores importantes en la explicación de estas métricas. El número total de individuos varió de acuerdo con la clase de edad del fuego, alcanzando un pico a los 15­40 años después del último incendio. La riqueza de especies y la diversidad de Shannon fueron más estables durante los años posteriores a incendios. Las tres métricas de la comunidad fueron más altas bajo condiciones post incendio que en las parcelas sin historial de fuego. Este patrón fue particularmente prevalente en parcelas forestadas, lo cual indica que el efecto negativo del fuego sobre los reptiles fue menor que el efecto negativo de la forestación. La composición de la comunidad varió por clase de edad del fuego, indicando la existencia de especies sucesionales tempranas y tardías (reptiles xéricos y saxícolas, respectivamente). La riqueza de especie fue 46% mas alta en áreas con una sola clase de edad del fuego que en aquellas con una mezcla de clases de edad del fuego, lo cual indica que los paisajes pirodiversos promovieron la diversidad de reptiles. Un cambio esperado hacia incendios más frecuentes sesgará la distribución de la edad del fuego hacia una predominancia de etapas tempranas, y esto será perjudicial para las comunidades de reptiles.

Time-loss injuries and illnesses at the FIFA world cup Qatar 2022.

The study aimed to analyse incidence and characteristics of time-loss injuries and illnesses during the FIFA World Cup Qatar 2022. Of 838 male football players, 705 consented to participate. Team medical staff reported 82 time-loss injuries, corresponding to an injury event incidence of 5.6 injuries/1000 h of total exposure (95%CI 4.5 to 7.0 injuries/1000 h), with a median of 2 time-loss injury events per team (IQR, 1 to 4.5, range 0-7). The total injury burden was 103 (95% CI 61 to 152) days per 1000 h. Muscle/tendon injuries had the highest incidence of tissue types (48 cases, 3.3/1000 h (95% CI 2.5 to 4.4), and hamstring muscle injuries were the most frequent diagnosis (16 cases, incidence 1.1/1000 h, 95% CI 0.6 to 1.8). Match injury event incidence was 20.6/1000 h (15.0 to 27.7) and training injury event incidence was 2.1/1000 h (1.4 to 3.1). The majority (52%) of sudden-onset injuries were non-contact injuries, 40% direct contact and 8% indirect contact. We recorded 15 time-loss illnesses, corresponding to an illness event incidence of 1.1 per 1000 competition days, (95% CI: 0.6 to 1.8), and illness burden of 2.1 (1.0 to 3.4) days lost per 1000 competition days. The most common illness was respiratory infection (12 cases, 80%). Match injury event incidence was the lowest in any FIFA World Cup since injuries have been monitored.

Immediate Impacts of Wildfires on Ground-dwelling macroinvertebrate Communities under Stones in Mediterranean Oak Forests.

Wildfires are considered a major disturbance to forest ecosystems in the Mediterranean countries of Southern Europe. Although ground-dwelling macroinvertebrates are crucial to many soil functions, there is a fundamental lack of understanding of how wildfires impact this community in the immediate term and of the role of stones in their survival. Hence, in the present study we assessed the immediate effects of wildfires in the ground-dwelling macroinvertebrate community found under stones by comparing communities in burnt and non-burnt Mediterranean oak forests. Our results revealed that stones allowed the survival of many taxa in the burnt area. However, abundance, richness, diversity, and equitability per stone were significantly lower at the burnt than unburnt sites. Furthermore, the results also showed that richness and abundance increased significantly with increasing stone depth and area, both at the burnt and unburnt sites. Significant changes at the trophic level were observed in the burnt area comparing to the unburnt, particularly a decline in predators. No significant differences were identified concerning habitat associations among taxa. Overall, this study stressed the role of stones as microhabitats and refuge for the ground-dwelling macroinvertebrate community during wildfires.

EpiGe: A machine-learning strategy for rapid classification of medulloblastoma using PCR-based methyl-genotyping.

Molecular classification of medulloblastoma is critical for the treatment of this brain tumor. Array-based DNA methylation profiling has emerged as a powerful approach for brain tumor classification. However, this technology is currently not widely available. We present a machine-learning decision support system (DSS) that enables the classification of the principal molecular groups-WNT, SHH, and non-WNT/non-SHH-directly from quantitative PCR (qPCR) data. We propose a framework where the developed DSS appears as a user-friendly web-application-EpiGe-App-that enables automated interpretation of qPCR methylation data and subsequent molecular group prediction. The basis of our classification strategy is a previously validated six-cytosine signature with subgroup-specific methylation profiles. This reduced set of markers enabled us to develop a methyl-genotyping assay capable of determining the methylation status of cytosines using qPCR instruments. This study provides a comprehensive approach for rapid classification of clinically relevant medulloblastoma groups, using readily accessible equipment and an easy-to-use web-application.t.

Burden of Disease and Cost of Illness of Inflammatory Bowel Diseases in Portugal.

Background: Inflammatory bowel diseases' (IBD) increasing incidence and prevalence place a heavy health and economic burden on society. Objectives: This study assesses the burden and cost of IBD in Portugal to support the definition of health policies, resource allocation, and patient care. Methods: The burden of disease was expressed using disability-adjusted life years (DALY). Costs were estimated considering the societal perspective, using a prevalence-based model and prices established by law. An expert panel composed of 5 expert Portuguese gastroenterologists and a patient-reported study were conducted to support the cost analysis and fill in information gaps. Results: In Portugal, with a prevalence of 24,069 IBD patients and an incidence of 15/100,000, the burden of disease was estimated at 6,067 DALYs: 507 resulting from premature deaths and 5,560 from disability. Total cost was estimated at EUR 146 million per year, with direct costs representing 59%. Average yearly cost per IBD patient is EUR 6,075, where 60% is related to Crohn's disease and 40% to ulcerative colitis (UC). Conclusion: This study estimates the annual health burden and cost of IBD in Portugal, thus generating information with the intent to raise awareness of the need to advance health policies as well as better clinical and economic decisions in this pathology.

Contexto: A crescente incidência e prevalência das Doenças Inflamatórias Intestinais (DII) representam um pesado fardo para a saúde e economia na sociedade. Objetivos: Este estudo avalia o custo e a carga da DII em Portugal, com o objetivo de suportar a definição de políticas de saúde, alocação de recursos e cuidados com o doente. Métodos: A carga da doença foi calculada utilizando anos de vida ajustados à incapacidade (DALY). Os custos foram estimados tendo em conta a perspetiva da sociedade, utilizando um modelo baseado na prevalência e preços estabelecidos por lei. Foi realizado um painel de peritos, composto por 5 gastroenterologistas portugueses, assim como um estudo de mercado a doentes, de forma a suportar a análise de custos e colmatar lacunas de informação. Resultados: Em Portugal, com uma prevalência de 24,069 doentes e uma incidência de 15/100,000, o peso das DII foi estimado em 6.067 DALYs: 507 dos quais resultantes de mortes prematuras e 5.560 de incapacidade. O custo total foi estimado em 146 milhões de euros por ano, com os custos diretos a representarem 59% do total. O custo médio anual por doente de DII é de 6.075 EUR, onde 60% está relacionado com Doença de Crohn (DC) e 40% com Colite Ulcerosa. Conclusão: Este estudo estima os encargos anuais para a saúde e o custo da DII em Portugal, gerando informação relevante, com o intuito de alertar para a necessidade de uma evolução nas políticas de saúde, assim como como suportar melhores decisões clínicas e económicas nesta patologia.

Metastatic hidradenocarcinoma: a report of two rare cases.

BACKGROUND: Hidradenocarcinoma is a rare malignant sweat gland tumour, characterized by a slow but aggressive course, with high rates of local recurrence and metastasis. Due to its rarity, histological criteria and therapeutic guidelines are poorly defined, posing a major challenge for clinicians and pathologists. OBJECTIVES: To present two new cases of metastatic hidradenocarcinoma as well as a review of the literature. MATERIALS & METHODS: We describe two case studies and a review of the literature based on a search using the MEDLINE (PubMed) electronic database. RESULTS: The first patient was a 61-year-old woman with a perimamillary hidradenocarcinoma that arose from the malignant transformation of a benign childhood lesion and developed regional lymph node metastases after wide excision and adjuvant radiotherapy. The second patient was a 63-year-old man who developed cutaneous and renal metastases several years after the complete excision of a lumbar hidradenocarcinoma. As far as we can ascertain, kidney metastasis from hidradenocarcinoma has not previously been described. CONCLUSION: Most authors recommend wide excision as the treatment of choice for hidradenocarcinoma, however, optimal adjuvant therapy remains to be determined. Our cases add to the limited knowledge available, but high-quality studies to find new effective treatments are needed.

Fitness, behavioral, and energetic trade-offs of different migratory strategies in a partially migratory species.

Alternative migratory strategies can coexist within animal populations and species. Anthropogenic impacts can shift the fitness balance between these strategies leading to changes in migratory behaviors. Yet some of the mechanisms that drive such changes remain poorly understood. Here we investigate the phenotypic differences, and the energetic, behavioral, and fitness trade-offs associated with four different movement strategies (long-distance and short-distance migration, and regional and local residency) in a population of white storks (Ciconia ciconia) that has shifted its migratory behavior over the last decades, from fully long-distance migration toward year-round residency. To do this, we tracked 75 adult storks fitted with GPS/GSM loggers with tri-axial acceleration sensors over 5 years, and estimated individual displacement, behavior, and overall dynamic body acceleration, a proxy for activity-related energy expenditure. Additionally, we monitored nesting colonies to assess individual survival and breeding success. We found that long-distance migrants traveled thousands of kilometers more throughout the year, spent more energy, and >10% less time resting compared with short-distance migrants and residents. Long-distance migrants also spent on average more energy per unit of time while foraging, and less energy per unit of time while soaring. Migratory individuals also occupied their nests later than resident ones, later occupation led to later laying dates and a lower number of fledglings. However, we did not find significant differences in survival probability. Finally, we found phenotypic differences in the migratory probability, as smaller sized individuals were more likely to migrate, and they might be incurring higher energetic and fitness costs than larger ones. Our results shed light on the shifting migratory strategies in a partially migratory population and highlight the nuances of anthropogenic impacts on species behavior, fitness, and evolutionary dynamics.

Mortality in a swiftly repurposed hospital in northeast Brazil during the first and second COVID-19 waves: A retrospective cohort study.

Background: The first months of the coronavirus disease 2019 (COVID-19) pandemic demanded rapid re-organization of available local resources. This study evaluated the performance of a private hospital in the Brazilian state of Ceará that was swiftly repurposed into a public tertiary COVID-19 centre during the first wave of the COVID-19 pandemic, and how it improved in the second wave. Methods: This retrospective cohort study included 2492 patients with COVID-19 at Hospital Estadual Leonardo da Vinci (HELV) during the first and second waves. Demographic, clinical and laboratory data were collected using a dedicated web platform (ResCOVID). A Poisson regression model was used to estimate factors associated with in-hospital mortality. Results: Differences in demographics and clinical features were found between the two waves. There was reduced in-hospital mortality during the second wave (36.2%) in comparison with the first wave (48.8%). Invasive mechanical ventilation showed the strongest association with increased risk of death in both waves {first wave: relative risk (RR) 4.28 [95% confidence interval (CI) 2.86-6.41], P<0.001; second wave: RR 12.94 (95% CI 3.4-49.12), P<0.001}. Conclusions: HELV was a pillar in the strategic public health plan to respond to COVID-19 in Ceará, helping to assist a group of moderate-to-severe cases and reduce the pressure on emergency and primary care facilities. Although mortality in intubated individuals remained high, there was an overall decrease in the in-hospital mortality rate in the second wave.

Small Bowel Adenocarcinoma in a Patient with Crohn's Disease: The Role of Balloon-Assisted Enteroscopy.

Introduction: Small bowel adenocarcinoma is a rare but well-known complication of Crohn's disease. Diagnosis can be challenging, as clinical presentation may mimic an exacerbation of Crohn's disease and imaging findings may be indistinguishable from benign strictures. The result is that the majority of cases are diagnosed at the time of operation or postoperatively at an advanced stage. Case Presentation: A 48-year-old male with a previous 20-year history of ileal stenosing Crohn's disease presented with iron deficiency anemia. The patient reported melena approximately 1 month earlier but was currently asymptomatic. There were no other laboratory abnormalities. Anemia was refractory to intravenous iron replacement. The patient underwent computerized tomography enterography, which revealed multiple ileal strictures with features suggesting underlying inflammation and an area of sacculation with circumferential thickening of adjacent bowel loops. Therefore, the patient underwent retrograde balloon-assisted small bowel enteroscopy, where an area of irregular mucosa and ulceration was found at the region of ileo-ileal anastomosis. Biopsies were performed and histopathological examination revealed tubular adenocarcinoma infiltrating the muscularis mucosae. The patient underwent right hemicolectomy plus segmental enterectomy of the anastomotic region where the neoplasia was located. After 2 months, he is asymptomatic and there is no evidence of recurrence. Discussion: This case demonstrates that small bowel adenocarcinoma may have a subtle clinical presentation and that computed tomography enterography may not be accurate enough to distinguish benign from malignant strictures. Clinicians must, therefore, maintain a high index of suspicion for this complication in patients with long-standing small bowel Crohn's disease. In this setting, balloon-assisted enteroscopy may be a useful tool when there is raised concern for malignancy, and it is expected that its more widespread use could contribute to an earlier diagnosis of this severe complication.

Introdução: O adenocarcinoma do intestino delgado é uma complicação rara mas bem estabelecida da doença de Crohn. O seu diagnóstico pode ser desafiante, na medida em que a apresentação clínica pode mimetizar uma agudização da doença de Crohn e os achados imagiológicos podem ser indistinguíveis de estenoses benignas. Em consequência, a maioria dos casos são diagnosticados durante ou após a cirurgia em estadio avançado. Descrição do caso: Um homem de 48 anos com antecedentes de doença de Crohn ileal estenosante, com 20 anos de evolução, apresentou-se com anemia ferropénica. O doente referia melenas aproximadamente um mês antes, mas encontrava-se atualmente assintomático. Não apresentava outras alterações laboratoriais de relevo. A anemia era refratária a suplementação com ferro endovenoso. Foi submetido a enterografia por tomografia computorizada, que revelou múltiplas estenoses ileais com caraterísticas sugestivas de atividade inflamatória e uma área de saculação com espessamento circunferencial das ansas de intestino delgado adjacentes. Assim, foi submetido a enteroscopia assistida por balão, onde se identificou uma área de mucosa irregular e ulceração na região da anastomose ileo-ileal. Biópsias desta área revelaram a presença de adenocarcinoma tubular com infiltração até à muscularis mucosae. O doente foi submetido a hemicolectomia direita com enterectomia segmentar da região da anastomose onde a neoplasia se encontrava localizada. Ao fim de 2 meses, o doente encontra-se assintomático e sem evidência de recorrência. Discussão: Este caso demonstra que o adenocarcinoma do intestino delgado pode ter uma apresentação clínica subtil e que a enterografia por tomografia computorizada pode não ter precisão suficiente para distinguir estenoses benignas de neoplasias malignas. Os clínicos devem, portanto, manter um elevado índice de suspeição diagnóstica para esta complicação em doentes com doença de Crohn ileal de longa duração. Neste contexto, a enteroscopia assistida por balão pode ser uma ferramenta útil em casos de suspeita de neoplasia maligna, esperando- se que possa contribuir para um diagnóstico mais precoce desta complicação severa.

Tephrosia toxicaria (Sw.) Pers. extracts: Screening by examining aedicidal action under laboratory and field conditions along with its antioxidant, antileishmanial, and antimicrobial activities.

An increase in the incidence of arboviral, microbial and parasitic infections, and to disorders related to oxidative stress has encouraged the development of adjuvant therapies based on natural formulations, such as those involving plant extracts. Thus, to expand the repertoire of the available therapeutic options, this study aimed to describe the versatility of Tephrosia toxicaria (Sw.) (Pers., 1807) extracts for the control of arbovirus vectors, as well as their antioxidant, antileishmanial, and antimicrobial potential. Among the aqueous and hydroethanolic extracts obtained, the hydroethanolic extract from roots (RHA) was identified as the most active larvicide extract demonstrating, respectively, the lowest lethal concentration (mg/mL) for 50%, 90% and 99% of Aedes aegypti (L., 1762) and Aedes albopictus (S., 1894) larvae, observed at 24 h (0.33, 0.84 and 1.80; 0.32, 0.70 and 1.32) and 48 h (0.17, 0.51 and 1.22; 0.26, 0.47 and 0.78) post-exposure. Field assays revealed that RHA (0.84 mg/mL) is a potential oviposition deterrent, reducing egg-laying by approximately 90%. RHA (0.1 mg/mL) also exhibited antioxidant activity for the following tests: total antioxidant capacity (286.86 mg AAE/g), iron (87.16%) and copper (25.64%) chelation, and superoxide scavenging (10%). In the cell culture assays, RHA (0.1 mg/mL) promoted regeneration of metabolic activity (92% cell viability) in cells exposed to oxidative stress. Furthermore, RHA displayed weak antileishmanial activity (IC50 = 3.53 mg/mL) against Leishmania amazonensis and not exhibit antimicrobial activity. The extraction favored the concentration of carbohydrates in RHA, in addition to lectins and protease inhibitors, with molecular masses estimated between 10 and 24 kDa. Cytotoxicity and phytotoxicity analyses of RHA suggested its biosecurity. Thus, RHA is a multivalent extract with insecticide and antioxidant properties at low and safe concentrations. However, others studies on its indirect toxic effects are ongoing to ensure the complete safety of RHA.

Long-term management practices successfully reduce bird-related electrical faults in a transmission grid increasingly used by white storks for nesting.

Bird nests on transmission lines can cause electrical faults which reduce service reliability. To address this problem, since the mid-90s, the Portuguese Transmission System Operator (TSO) has undertaken management actions to discourage white storks Ciconia ciconia from nesting in hazardous locations of the pylons. Here, we compiled and analyzed an 18-year series of data on electrical faults, TSO management actions to tackle these, and stork nests on transmission pylons in Portugal to: (a) determine the relative importance of bird-related faults over the total number of faults; (b) describe variations in bird-related faults across time (season of the year and time of the day); (c) describe spatial variations in bird-related faults and their association with the occurrence of white stork nests on pylons; and (d) analyze the trends, over the years, of the number of white stork nests on pylons, the TSO management actions and their effectiveness in reducing bird-related fault rates. Overall, birds accounted, on average, for 25.3% of the electrical faults in the transmission network, with the vast majority being attributed to white storks. The seasonal pattern of bird-related faults showed higher rates in April and in October-November. Faults occurred more often during the night period, when storks spend more time on the pylons. We found a positive spatial relationship between the electrical fault rate and the proportion of pylons with stork nests (and the correlated number of nests per 100 km of line). There was, however, considerable variation in the fault rates not explained by the stork nest variables, particularly during the non-breeding season. The TSO management actions (namely removal/translocation of nests in hazardous locations of the pylons, installation of anti-perching devices and provision of alternative nesting platforms) significantly reduced, as a whole, the annual number of bird-related faults between 2001 and 2018, despite the three-fold increase in the number of white stork nests on transmission pylons. A deeper understanding of how white storks use the transmission pylons outside the breeding season is needed, so that targeted management actions can be taken to reduce the remaining bird-related fault rates to residual levels.

On-demand cell-autonomous gene therapy for brain circuit disorders.

Several neurodevelopmental and neuropsychiatric disorders are characterized by intermittent episodes of pathological activity. Although genetic therapies offer the ability to modulate neuronal excitability, a limiting factor is that they do not discriminate between neurons involved in circuit pathologies and "healthy" surrounding or intermingled neurons. We describe a gene therapy strategy that down-regulates the excitability of overactive neurons in closed loop, which we tested in models of epilepsy. We used an immediate early gene promoter to drive the expression of Kv1.1 potassium channels specifically in hyperactive neurons, and only for as long as they exhibit abnormal activity. Neuronal excitability was reduced by seizure-related activity, leading to a persistent antiepileptic effect without interfering with normal behaviors. Activity-dependent gene therapy is a promising on-demand cell-autonomous treatment for brain circuit disorders.

Canopy arthropod declines along a gradient of olive farming intensification.

Arthropod declines have been linked to agricultural intensification. However, information about the impacts of intensification is still limited for many crops, as is our understanding of the responses of different arthropod taxa and trophic groups, thus hindering the development of effective mitigation measures. We investigated the impacts of olive farming intensification on canopy-dwelling arthropods in the Mediterranean region. Intensification involves the increased use of agrochemicals, mechanisation and irrigation, but also structural changes from traditional orchards with low densities of large and old trees, to intensive and superintensive orchards with high to very high densities of smaller and younger trees, respectively. Canopy arthropods were vacuum-sampled at 53 sites representing the three orchard intensification levels, in spring, summer and autumn 2017. We evaluated how the arthropod community varied across intensification levels, and in response to orchard structure, management and landscape context. We found no changes in the diversity of arthropod taxa across intensification levels after correcting for sample coverage, but arthropod abundance declined markedly along the intensification gradient. Decreased abundance was associated with changes in orchard structure, lower herbaceous cover, and higher herbicide and insecticide use. The abundance of a specialized olive pest was lower in landscapes with higher woodland cover. The negative effects of intensification were stronger in spring and summer than in autumn, and parasitoids and predators were particularly affected. Overall, results suggest that retaining herbaceous cover, reducing agrochemical inputs and preserving natural woody elements in the landscape, may contribute to mitigate impacts of olive farming intensification on canopy arthropods, particularly on beneficial species.

Protect European green agricultural policies for future food security.

European green agricultural policies have been relaxed to allow cultivation of fallow land to produce animal feed and meet shortfalls in exports from Ukraine and Russia. However, conversion of semi-natural habitats will disproportionately impact long term biodiversity and food security.

Gravidade respiratória e fatores sociodemográficos associados ao desfecho clínico de pacientes com COVID-19 no Ceará / Respiratory severity and sociodemographic factors associated with the clinical outcome of patients with COVID-19 in Ceará

A COVID-19 causa complicações pulmonares importantes, oferecendo risco à vida. Objetivou-se compreender como a gravidade respiratória e os fatores sociodemográficos interferem no desfecho clínico de pacientes com COVID-19. Pesquisa descritiva, transversal, de abordagem quantitativa, realizada em hospital de referência em Fortaleza-Ceará, Brasil. Os dados foram coletados de novembro/2020 a setembro/2021, totalizando 470 pacientes com testagem positiva, sendo analisados pelo programa Microsoft Office Excel 2019. Quanto ao gênero, 56,8% eram do sexo masculino, com média de idade de 57,32 anos e 67,1% dos pacientes que evoluíram com alta hospitalar não apresentaram suporte de oxigênio à internação. Indivíduos residentes em regiões com Índice de Desenvolvimento Humano muito baixo foram mais suscetíveis à contaminação e maior mortalidade (46,1%), e as doenças crônicas degenerativas foram preditivas de letalidade. Os perfis sociodemográfico e clínico influenciaram os aspectos fisiopatológicos de desenvolvimento da doença e a evolução preditiva relacionada à permanência hospitalar e ao desfecho.

COVID-19 causes major, life-threatening lung complications. This study aimed to understand how respiratory severity and sociodemographic factors affect the clinical outcome of patients with COVID-19. It was a descriptive, cross-sectional research with quantitative approach conducted in a referral hospital in Fortaleza-Ceará, Brazil. Data collection occurred from November 2020 to September 2021, totaling 470 patients who tested positive for COVID-19, being analyzed in Microsoft Office Excel 2019. Regarding gender, 56.8% were male, with a mean age of 57.32 years and 67.1% of patients who evolved to hospital discharge did not have oxygen support at admission. Individuals living in regions with very low Human Development Index were more susceptible to contamination and higher mortality (46.1%), and chronic degenerative diseases were predictive of lethality. Sociodemographic and clinical profiles influenced the pathophysiological aspects of disease development and the predictive evolution related to hospital stay and outcome.

A homozygous MED11 C-terminal variant causes a lethal neurodegenerative disease.

PURPOSE: The mediator (MED) multisubunit-complex modulates the activity of the transcriptional machinery, and genetic defects in different MED subunits (17, 20, 27) have been implicated in neurologic diseases. In this study, we identified a recurrent homozygous variant in MED11 (c.325C>T; p.Arg109Ter) in 7 affected individuals from 5 unrelated families. METHODS: To investigate the genetic cause of the disease, exome or genome sequencing were performed in 5 unrelated families identified via different research networks and Matchmaker Exchange. Deep clinical and brain imaging evaluations were performed by clinical pediatric neurologists and neuroradiologists. The functional effect of the candidate variant on both MED11 RNA and protein was assessed using reverse transcriptase polymerase chain reaction and western blotting using fibroblast cell lines derived from 1 affected individual and controls and through computational approaches. Knockouts in zebrafish were generated using clustered regularly interspaced short palindromic repeats/Cas9. RESULTS: The disease was characterized by microcephaly, profound neurodevelopmental impairment, exaggerated startle response, myoclonic seizures, progressive widespread neurodegeneration, and premature death. Functional studies on patient-derived fibroblasts did not show a loss of protein function but rather disruption of the C-terminal of MED11, likely impairing binding to other MED subunits. A zebrafish knockout model recapitulates key clinical phenotypes. CONCLUSION: Loss of the C-terminal of MED subunit 11 may affect its binding efficiency to other MED subunits, thus implicating the MED-complex stability in brain development and neurodegeneration.

Individual variability in space use near power lines by a long-lived territorial raptor.

Evaluating species responses to anthropogenic infrastructures and other habitat changes is often used to assess environmental impacts and to guide conservation actions. However, such studies are generally carried out at the population level, disregarding inter-individual variability. Here, we investigate population- and individual-level responses toward power lines of a territorial raptor, the Bonelli's eagle Aquila fasciata. We used GPS-PTT tracking data of 17 adult eagles to model space use as a function of distance to transmission and distribution lines, while accounting for other habitat features known to affect this species. At population level, eagles increased the intensity of space use in the proximity of power lines (up to 1,000 m), suggesting an attraction effect. At individual level, some eagles shared the general population attraction pattern, while others showed reduced intensity of space use in the proximity of power lines. These differential responses were unrelated to the sex of individuals, but were affected by the characteristics of the power grid, with a tendency for apparent attraction to be associated with individuals occupying home ranges with a denser network of transmission lines and transmission pylons. However, the study could not rule out the operation of other potentially influential factors, such as individual idiosyncrasies, the spatial distribution of prey availability, and the availability of natural perches and nesting sites. Overall, these results suggest that power lines may drive different behaviors and have differential impacts across individuals, with those attracted to the proximity of power lines potentially facing increased risk of mortality through electrocution and collision, and those avoiding power lines being potentially subject to exclusion effects. More generally, our results reinforce the need to understand individual variability when assessing and mitigating impacts of anthropogenic infrastructures.

Indigo Carmine Hemodynamic Studies to Treat Vasoplegia Induced by Compound 48/80 in a Swine Model of Anaphylaxis.

INTRODUCTION: There are many reasons to believe that the nitric oxide/guanosine 3'5' - cyclic monophosphate (or NO/cGMP) pathway on vasoplegic states is underestimated. To study indigo carmine (IC) as an alternative to methylene blue was the investigation rationale. METHODS: The IC (3mg/kg intravenous infusion) study protocol included five experimental groups; 1) Control group - saline was injected at 0 and 10 minutes; 2) IC group - IC was injected at 0 and saline at 10 minutes; 3) compound 48/80 (C48/80) group - C48/80 was injected at 0 minute and saline at 10 minutes; 4) C48/80 + IC group - C48/80 was injected at 0 minute and IC at 10 minutes; and 5) IC + C48/80 group - IC was injected at 0 minute and C48/80 at 10 minutes. The studies were carried out by registering and measuring hemodynamic and blood gasometric parameters, including continuous cardiac output. RESULTS: 1) The effects of the drugs (IC and C48/80) were more evident in the first 20 minutes of recording; 2) hypotensive responses were more pronounced in the C48/80 groups; 3) IC isolated or applied before C48/80 caused transient pulmonary hypertension; and 4) after the first 20 minutes, the pressure responses showed stability with apparent hypotension more pronounced in the C48/80 groups. Clinical observations showed significant hemodynamic instability and catastrophic anaphylactic reactions (agitation, pulmonary hypertension, severe bronchospasm, urticaria, high-intensity cyanosis, violent gastric hypersecretion, and ascites). CONCLUSION: A global results analysis showed differences between groups only in the first 20 minutes of the experiments.