Shifts in plant functional groups along an aridity gradient in a tropical dry forest.

Increasing aridity associated with climate change may lead to the crossing of critical ecosystem thresholds in drylands, compromising ecosystem services for millions of people. In this context, finding tools to detect at early stages the effects of increasing aridity on ecosystems is extremely urgent to avoid irreversible damage. Here, we assess shifts in plant community functional structure along a spatial aridity gradient in tropical dryland (Brazilian Caatinga), to select the most appropriate plant functional groups as ecological indicators likely useful to predict temporal ecosystem trajectories in response to aridity. We identified seven plant functional groups based on 13 functional traits associated with plant establishment, defense, regeneration, and dispersal, whose relative abundances changed, linearly and non-linearly, with increasing aridity, showing either increasing or decreasing trends. Of particular importance is the increase in abundance of plants with high chemical defense and Crassulacean Acid Metabolism (CAM) photosynthetic pathway, with increasing aridity. We propose the use of these functional groups as early warning indicators to detect aridity impacts on these dryland ecosystems and shifts in ecosystem functioning. This information can also be used in the elaboration of mitigation and ecological restoration measures to prevent and revert current and future climate change impacts on tropical dry forests.

Food matters: Dietary shifts increase the feasibility of 1.5°C pathways in line with the Paris Agreement.

A transition to healthy diets such as the EAT-Lancet Planetary Health Diet could considerably reduce greenhouse gas (GHG) emissions. However, the specific contributions of dietary shifts for the feasibility of 1.5°C pathways remain unclear. Here, we use the open-source integrated assessment modeling (IAM) framework REMIND-MAgPIE to compare 1.5°C pathways with and without dietary shifts. We find that a flexitarian diet increases the feasibility of the Paris Agreement climate goals in different ways: The reduction of GHG emissions related to dietary shifts, especially methane from ruminant enteric fermentation, increases the 1.5°C compatible carbon budget. Therefore, dietary shifts allow to achieve the same climate outcome with less carbon dioxide removal (CDR) and less stringent CO2 emission reductions in the energy system, which reduces pressure on GHG prices, energy prices, and food expenditures.

Differential Diagnosis or Etiology: A Case Report on Amyotrophic Lateral Sclerosis-like Neuropathy Associated with HIV Infection.

BACKGROUND: Retroviruses are described as a risk factor for chronic neuropathy. However, it is still unknown if they can work as amyotrophic lateral sclerosis triggers. Over the years, some cases of this association have been described with heterogenous disclosures. CASE REPRESENTATION: This study aimed to report a case of HIV and ALS-like neuropathy and briefly discuss peculiarities of clinical aspects, such as physiopathology and treatment options. The patient underwent neurological examination associated with blood tests, electromyography, analysis of cerebrospinal fluid, and imaging studies. DISCUSSION: A non-systematic review was performed in major databases regarding the topic. The case presented mixed upper and lower motor neuron signs and was framed as a probable case of ALS following the present criteria. CONCLUSION: After a short follow-up and viral load cleansing, neurological stabilization was achieved.

Fossil extraction bans and carbon taxes: Assessing their interplay through multiple models.

Given concerns about the ambition and effectiveness of current climate policies, a case has been made for the combination of demand side policies such as carbon pricing with supply side bans on fossil fuel extraction. However, little is known about their interplay in the context of climate stabilization strategies. Here, we present a multi-model assessment quantifying the effectiveness of supply side policies and their interactions with demand-side ones. We explore a variety of fossil fuel bans with four integrated assessment models and find that international supply side policies reduce carbon emissions but not at sufficient levels to stabilize temperature increase to well below 2°C. When combined with demand side policies, supply side policies reduce the required carbon price, dampen reliance on CO2 removal technologies, and increase investment in renewable energy. The results indicate the opportunity to integrate fossil fuel bans alongside price-based policies when exploring pathways to reach ambitious mitigation targets.

Comparing energy system optimization models and integrated assessment models: Relevance for energy policy advice.

Background: The transition to a climate neutral society such as that envisaged in the European Union Green Deal requires careful and comprehensive planning. Integrated assessment models (IAMs) and energy system optimisation models (ESOMs) are both commonly used for policy advice and in the process of policy design. In Europe, a vast landscape of these models has emerged and both kinds of models have been part of numerous model comparison and model linking exercises. However, IAMs and ESOMs have rarely been compared or linked with one another. Methods: This study conducts an explorative comparison and identifies possible flows of information between 11 of the integrated assessment and energy system models in the European Climate and Energy Modelling Forum. The study identifies and compares regional aggregations and commonly reported variables. We define harmonised regions and a subset of shared result variables that enable the comparison of scenario results across the models. Results: The results highlight how power generation and demand development are related and driven by regional and sectoral drivers. They also show that demand developments like for hydrogen can be linked with power generation potentials such as onshore wind power. Lastly, the results show that the role of nuclear power is related to the availability of wind resources. Conclusions: This comparison and analysis of modelling results across model type boundaries provides modellers and policymakers with a better understanding of how to interpret both IAM and ESOM results. It also highlights the need for community standards for region definitions and information about reported variables to facilitate future comparisons of this kind. The comparison shows that regional aggregations might conceal differences within regions that are potentially of interest for national policy makers thereby indicating a need for national-level analysis.

How Do Taxonomic and Functional Diversity Metrics Change Along an Aridity Gradient in a Tropical Dry Forest?

Ecological indicators based on biodiversity metrics are valuable and cost-effective tools to quantify, track and understand the effects of climate change on ecosystems. Studying changes in these indicators along climatic gradients in space is a common approach to infer about potential impacts of climate change over time, overcoming the limitations of lack of sufficiently long time-series data. Here, we studied the response of complementary biodiversity metrics in plants: taxonomic diversity (species richness and Simpson index) and functional diversity (diversity and redundancy) in 113 sampling sites along a spatial aridity gradient (from 0.27 to 0.69 of aridity index-AI) of 700 km in a Tropical dry forest. We found different responses of taxonomic and functional diversity metrics to aridity. Species diversity showed a hump-shaped curve peaking at intermediate levels of aridity between 0.38 and 0.52 AI as an ecotone, probably because it is where most species, from both drier and more mesic environments, still find conditions to co-exist. Functional diversity showed a positive linear relation with increasing aridity, suggesting higher aridity favors drought-adapted species with diverse functional traits. In contrast, redundancy showed a negative linear relation with increasing aridity, indicating that drier sites have few species sharing the same functional traits and resource acquisition strategies. Thus, despite the increase in functional diversity toward drier sites, these communities are less resilient since they are composed of a small number of plant species with unique functions, increasing the chances that the loss of one of such "key species" could lead to the loss of key ecosystem functions. These findings show that the integration of complementary taxonomic and functional diversity metrics, beyond the individual response of each one, is essential for reliably tracking the impacts of climate change on ecosystems. This work also provides support to the use of these biodiversity metrics as ecological indicators of the potential impact of climate change on drylands over time.

Lead-DBS: an additional tool for stereotactic surgery.

OBJECTIVE: Use Lead-DBS software to analyze stereotactical surgical outcome of an operated population and demonstrate that small target deviations do not compromise the stimulation of desired structures, even with small amperages. METHODS: Image exams of patients submitted to deep brain stimulation for movement disorders treatment were processed in Lead-DBS software. Electrode stereotactic coordinates were subtracted from the planned target and those deviations, compared among different anatomical targets and sides operated firstly and secondly. We also quantified the frequency of relation between the activated tissue volume and the planned target through computer simulations. RESULTS: None of the 16 electrodes were exactly implanted at the planned coordinates. A stimulation of 3 mA reached 62.5% of the times the planned coordinates, rising to 68.75% with a 3,5 mA. No statistical significance was demonstrated in any comparison of laterality and anatomical sites. CONCLUSIONS: The simulation of small amperage fields could reach the intended target even when electrode placement is suboptimal. Furthermore, such a goal can be achieved without overlapping the volume of activated tissue with undesired structures. Software Lead-DBS proved to be a valuable complementary asset for surgical stereotactical result assessment.

Lead-DBS: an additional tool for stereotactic surgery

SUMMARY OBJECTIVE: Use Lead-DBS software to analyze stereotactical surgical outcome of an operated population and demonstrate that small target deviations do not compromise the stimulation of desired structures, even with small amperages. METHODS: Image exams of patients submitted to deep brain stimulation for movement disorders treatment were processed in Lead-DBS software. Electrode stereotactic coordinates were subtracted from the planned target and those deviations, compared among different anatomical targets and sides operated firstly and secondly. We also quantified the frequency of relation between the activated tissue volume and the planned target through computer simulations. RESULTS: None of the 16 electrodes were exactly implanted at the planned coordinates. A stimulation of 3 mA reached 62.5% of the times the planned coordinates, rising to 68.75% with a 3,5 mA. No statistical significance was demonstrated in any comparison of laterality and anatomical sites. CONCLUSIONS: The simulation of small amperage fields could reach the intended target even when electrode placement is suboptimal. Furthermore, such a goal can be achieved without overlapping the volume of activated tissue with undesired structures. Software Lead-DBS proved to be a valuable complementary asset for surgical stereotactical result assessment.

Complicated Cerebral Venous Thrombosis During the First Trimester of Pregnancy.

Pregnancy and puerperium are known conditions associated with venous thrombotic events, which may present atypically in cases such as cerebral venous thrombosis. Since these are uncommon events, there is a paucity of reports and protocols for the management of these patients, resulting in no clear consensus in the literature. We report a case of a woman, nine weeks pregnant, who developed thrombosis of the right transverse and superior sagittal sinuses. Our diagnosis was made with computed tomography angiography, and due to a significant midline shift, an emergency decompressive hemicraniectomy was required. Although medical and surgical therapies for intracranial hypertension and anticoagulation were optimized in accordance with current medical literature, the patient suffered a spontaneous abortion and remained with significant neurological sequelae.

The response of plant functional traits to aridity in a tropical dry forest.

Drylands are experiencing an overall increase in aridity that is predicted to intensify in the future due to climate change. This may cause changes in the structure and functioning of dryland ecosystems, affecting ecosystem services and human well-being. Therefore, detecting early signs of ecosystem change before irreversible damage takes place is important. Thus, here we used a space-for-time substitution approach to study the response of the plant community to aridity in a Tropical dry forest (Caatinga, Brazil), and infer potential consequences of climate change. We assessed plant functional structure using the community weighted mean (CWM) and functional diversity, measured through functional dispersion (FDis), along a 700 km climatic gradient. We studied 13 functional traits, reflecting strategies associated with establishment, defense, regeneration, and dispersal of the most abundant 48 plant species in 113 sampling sites. Spearman correlations were used to test the relation between aridity and single-trait functional metrics. Aridity was a major environmental filter of the plant community functional structure. We found a higher abundance of species with deciduous leaves, zoochorous dispersal, fleshy fruits, chemical defense exudation and spinescence, and crassulacean acid metabolism towards more arid sites, at the expense of species with evergreen and thicker leaves, autochory dispersal, and shrub growth-form. The FDis of leaf type and thickness decreased with aridity, whereas FDis of fruit type, photosynthetic pathway, and defense strategies increased. Our findings provide functional indicators to early detect climate change impacts on Caatinga structure and functioning, to timely adopt preventive measures (e.g. conservation of forest remnants) and restoration actions (e.g. introduction of species with specific functional traits) in this threatened and unique ecosystem.

Structural and functional shifts of soil prokaryotic community due to Eucalyptus plantation and rotation phase.

Agriculture, forestry and other land uses are currently the second highest source of anthropogenic greenhouse gases (GHGs) emissions. In soil, these gases derive from microbial activity, during carbon (C) and nitrogen (N) cycling. To investigate how Eucalyptus land use and growth period impact the microbial community, GHG fluxes and inorganic N levels, and if there is a link among these variables, we monitored three adjacent areas for 9 months: a recently planted Eucalyptus area, fully developed Eucalyptus forest (final of rotation) and native forest. We assessed the microbial community using 16S rRNA gene sequencing and qPCR of key genes involved in C and N cycles. No considerable differences in GHG flux were evident among the areas, but logging considerably increased inorganic N levels. Eucalyptus areas displayed richer and more diverse communities, with selection for specific groups. Land use influenced communities more extensively than the time of sampling or growth phase, although all were significant modulators. Several microbial groups and genes shifted temporally, and inorganic N levels shaped several of these changes. No correlations among microbial groups or genes and GHG were found, suggesting no link among these variables in this short-rotation Eucalyptus study.

The Galactose-Binding Lectin Isolated from Vatairea macrocarpa Seeds Enhances the Effect of Antibiotics Against Staphylococcus aureus-Resistant Strain.

The use of natural products together with standard antimicrobial drugs has recently received more attention as a strategy to combat infectious diseases caused by multidrug-resistant (MDR) microorganisms. This study aimed to evaluate the capacity of a galactose-binding lectin from Vatairea macrocarpa seeds (VML) to modulate antibiotic activity against standard and MDR Staphylococcus aureus and Escherichia coli bacterial strains. The minimum inhibitory concentration (MIC) obtained for VML against all strains was not clinically relevant (MIC ≥ 1024 µg/mL). However, when VML was combined with the antibacterial drugs gentamicin, norfloxacin and penicillin, a significant increase in antibiotic activity was observed against S. aureus, whereas the combination of VML and norfloxacin presented decreased and, hence, antagonistic antibiotic activity against E. coli. By its inhibition of hemagglutinating activity, gentamicin (MIC = 50 mM) revealed its interaction with the carbohydrate-binding site (CBS) of VML. Using molecular docking, it was found that gentamicin interacts with residues that constitute the CBS of VML with a score of - 120.79 MDS. It is this interaction between the antibiotic and the lectin's CBS that may be responsible for the enhanced activity of gentamicin in S. aureus. Thus, our results suggest that the VML can be an effective modulating agent against S. aureus. This is the first study to report the effect of lectins as modulators of bacterial sensitivity, and as such, the outcome of this study could lay the groundwork for future research involving the use of lectins and conventional antibiotics against such infectious diseases such as community-acquired methicillin-resistant S. aureus (MRSA).

Short-term effect of Eucalyptus plantations on soil microbial communities and soil-atmosphere methane and nitrous oxide exchange.

Soil greenhouse gas (GHG) emissions are a significant environmental problem resulting from microbially-mediated nitrogen (N) and carbon (C) cycling. This study aimed to investigate the impact of Eucalyptus plantations on the structure and function of a soil microbial community, and how resulting alterations may be linked to GHG fluxes. We sampled and monitored two adjacent Eucalyptus plantations-a recently logged site that harbored new seedlings and an adult plantation-and compared them to a site hosting native vegetation. We used 16S rRNA gene sequencing and qPCR amplifications of key nitrogen and methane cycle genes to characterize microbial structure and functional gene abundance and compared our data with soil parameters and GHG fluxes. Both microbial community attributes were significantly affected by land use and logging of Eucalyptus plantations. The genes nosZ and archaeal amoA were significantly more abundant in native forest than in either young or old Eucalyptus plantations. Statistical analyses suggest that land use type has a greater impact on microbial community structure and functional gene abundance than Eucalyptus rotation. There was no correlation between GHG fluxes and shifts in microbial community, suggesting that microbial community structure and functional gene abundance are not the main drivers of GHG fluxes in this system.

Primary Repair of a Complex Panfacial Fracture by Dog Bite.

Facial fractures due to dog attacks have an unknown incidence rate. To date, only 41 cases of canine bite trauma in a pediatric patient, associated with facial fracture, have been reported in the literature. As major species of involving dogs are the American pitbull terrier and rottweiler. Due to the intense kinematics of this trauma, the treatment becomes complex. Thus, attention to the primary repair of such complex lesions ensures satisfactory results, which is the focus of this discussion. The purpose of this review was to analyze how different ways to approach this type of trauma in children for clarification or correct management. In addition, we address the treatment plan of a complex case of panfacial fracture by a canine bite in a 4-year-old patient. According to a review addressed, the main involved are orbit, nasal, and zygomatic. Antibiotic therapy is indicated for infected bite wounds and wounded considerations at risk of infection, with high complexity and when involving important structures such as bones, vessels, and joints. The state of tetanus immunization and the risk of rabies infection should be routinely addressed in the management of the bite wound.

Resting state connectivity patterns with near-infrared spectroscopy data of the whole head.

Resting state cerebral dynamics has been a useful approach to explore the brain's functional organization. In this study, we employed graph theory to deeply investigate resting state functional connectivity (rs-FC) as measured by near-infrared spectroscopy (NIRS). Our results suggest that network parameters are very similar across time and subjects. We also identified the most frequent connections between brain regions and the main hubs that participate in the spontaneous activity of brain hemodynamics. Similar to previous findings, we verified that symmetrically located brain areas are highly connected. Overall, our results introduce new insights in NIRS-based functional connectivity at rest.

Incêndio em edificações hospitalares: conhecimento dos profissionais de enfermagem sobre prevenção, combate e escape / Fires in hospital buildings: knowledge held by nursing professionals regarding prevention, combat and escape / Incendios en edificios hospitalarios: conocimiento de profesionales de enfermería sobre prevención, combate y escape

Objetivou-se analisar o conhecimento e conduta dos profissionais da enfermagem acerca da prevenção, combate e escape de incêndios hospitalares. Estudo de caráter descritivo, foi realizado num hospital público de ensino, de Goiânia/GO, com 109 profissionais de enfermagem. Os dados foram coletados em 2011, por meio de entrevistas estruturadas com questionário e analisados por meio de estatística descritiva. A maioria entrevistada era do gênero feminino, técnicos/auxiliares de enfermagem (67,9%), que conhecia o telefone do Corpo de Bombeiros (85,3%) e onde estão extintores (80,7%), mas não sabiam utilizá-los (69,7%). A maior parte dos entrevistados não conhecia a rota de fuga (57,8%) e, em caso de incêndio, acionaria bombeiros, orientaria as pessoas à saída, faria uso do extintor ou pularia janelas. As lacunas identificadas indicam necessidade de treinamento e estabelecimento de rotas de fuga para garantir comportamento adequado, pois de nada adiantam recursos tecnológicos sem pessoas que possam agir preventivamente. Reduzir riscos significa segurança e qualidade institucional.

This study analyzes the knowledge and conduct of nursing professionals regarding hospital fire prevention, combat and escape. A descriptive study conducted in a public teaching hospital in Goiânia/GO, Brazil, with 109 nursing professionals. Data was collected in 2011 using structured interviews with questionnaires, and descriptive statistics for analysis. Most subjects were female, nursing technicians/assistants (67.9%), knew the Fire Department's number (85.3%) and the extinguisher's location (80.7%), but ignored how they functioned (69.7%). Also, 57.8% of interviewees ignored the exit routes and, in case of fire, would alert the fire department, guide people towards the exit, use the extinguisher or jump out of the windows. The gaps identified in this study indicate that in order to guarantee adequate conduct, fire training is necessary, as is the establishment of escape routes, since technological resources are useless without individuals who can act preventively. Risk reduction implies in institutional safety and quality.

Se objetivó analizar el conocimiento y conducta de profesionales de enfermería sobre prevención, combate y escape de incendios hospitalarios. Estudio descriptivo, realizado en hospital público de enseñanza en Goiânia/GO, con 109 profesionales de enfermería. Datos recolectados en 2011 mediante entrevistas estructuradas con cuestionario, analizadas según estadística descriptiva. A mayoría de los entrevistados era de sexo femenino, técnicos/auxiliares de enfermería (67,9%), conocía el teléfono del Cuerpo de Bomberos (85,3%) y la ubicación de los extintores (80,7%), aunque no sabía utilizarlos (69,7%). La mayoría del personal entrevistado desconocía la ruta de fuga (57,8%) y, en caso de incendio, accionaría bomberos, orientaría personas hacia la salida, utilizaría el extintor o saltaría por ventanas. Las carencias identificadas indican necesidad de entrenamiento y establecimiento de rutas de fuga para garantizar comportamientos adecuados, pues de poco sirven los recursos técnicos sin personas que puedan actuar preventivamente. Reducir riesgos significa seguridad y calidad institucional.

Enabling outsourcing XDS for imaging on the public cloud.

Picture Archiving and Communication System (PACS) has been the main paradigm in supporting medical imaging workflows during the last decades. Despite its consolidation, the appearance of Cross-Enterprise Document Sharing for imaging (XDS-I), within IHE initiative, constitutes a great opportunity to readapt PACS workflow for inter-institutional data exchange. XDS-I provides a centralized discovery of medical imaging and associated reports. However, the centralized XDS-I actors (document registry and repository) must be deployed in a trustworthy node in order to safeguard patient privacy, data confidentiality and integrity. This paper presents XDS for Protected Imaging (XDS-p), a new approach to XDS-I that is capable of being outsourced (e.g. Cloud Computing) while maintaining privacy, confidentiality, integrity and legal concerns about patients' medical information.

Non-flat audiograms in sensorineural hearing loss and speech perception.

OBJECTIVE: The audibility thresholds for the sound frequency of 137 upward- and downward-sloping audiograms showing sensorineural hearing loss were selected and analyzed in conjunction with speech recognition thresholds obtained from individuals seen at a public otolaryngology clinic to determine which frequencies in slope audiograms best represent speech recognition thresholds. METHOD: The linear regression model and mean square error were used to determine the associations between the threshold values. RESULT: The mean square error identified larger errors when using thresholds of 500, 1000, and 2000 Hz than when using audibility thresholds of 500, 1000, 2000, and 4000 Hz. The linear regression model showed a higher correlation (91%) between the audiogram thresholds for frequencies of 500, 1000, 2000, and 4000 Hz than for the frequencies of 500, 1000, and 2000 Hz (88%). CONCLUSION: Frequencies of 500, 1000, 2000, and 4000 Hz were the most significant in predicting the speech recognition threshold.

Non-flat audiograms in sensorineural hearing loss and speech perception

OBJECTIVE: The audibility thresholds for the sound frequency of 137 upward- and downward-sloping audiograms showing sensorineural hearing loss were selected and analyzed in conjunction with speech recognition thresholds obtained from individuals seen at a public otolaryngology clinic to determine which frequencies in slope audiograms best represent speech recognition thresholds. METHOD: The linear regression model and mean square error were used to determine the associations between the threshold values. RESULT: The mean square error identified larger errors when using thresholds of 500, 1000, and 2000 Hz than when using audibility thresholds of 500, 1000, 2000, and 4000 Hz. The linear regression model showed a higher correlation (91%) between the audiogram thresholds for frequencies of 500, 1000, 2000, and 4000 Hz than for the frequencies of 500, 1000, and 2000 Hz (88%). CONCLUSION: Frequencies of 500, 1000, 2000, and 4000 Hz were the most significant in predicting the speech recognition threshold. .

Carbúnculo Hemático

O carbúnculo hemático, é causado por uma bactéria anaeróbica e gram-positiva, classificado como zoonose que ataca principalmente bovinos, ovinos e eqüinos causando uma septicemia rapidamente mortal, não sendo em alguns casos possível o tratamento, por um de seus primeiros sintomas ser a morte do animal. No homem produz uma lesão cutânea, conhecida pelo nome de pústula maligna, e a bactéria pode passar para o sangue e determinar uma septicemia grave