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Abstract 2D MXenes find applications in several technology fields. Solution processing techniques can facilitate the integration of these materials within the technological supply chain. Here, a highly concentrated (up to 1.5 g L−1) and stable dispersion of 2D Ti3C2Tx MXene flakes is produced by an environmentally friendly liquid phase exfoliation process (LPE) in dihydrolevoglucosenone (Cyrene). The flakes preserve their elemental composition after 6 months, while those exfoliated in N‐Methyl‐2‐pyrrolidone (NMP), a commonly used solvent, undergo significant oxidation. The cytotoxicity of the MXene flakes in Cyrene and in NMP is investigated by assessing the cellular viability in a human keratinocyte (HaCaT) cell line, which is a relevant model for skin applications. The data show that the MXene flakes in Cyrene induce cytotoxic effects for a dose > 1 µg cm−2, as similarly observed for the MXene flakes in NMP. Efforts are made to overcome this by collecting the MXene flakes and redispersing them in a solution of bovine serum albumin (BSA). MXene in BSA does not affect cellular viability and cell morphology, possibly due to the formation of a protective protein corona around the individual MXene flakes. These findings illustrate an environmentally friendly strategy to produce biocompatible 2D MXene for biomedical applications.

Background: Men’s access to sexual health care is influenced by the nurses’ symbolic universes, translated into maps of signification and normative idealization that structure their practices. Aim: The aim of the study was to analyze nurses’ social representations of men’s sexual health, considering the barriers and possibilities in accessing health care. Methods: Descriptive study with qualitative approach. Data were collected through an online focus group with 9 Portuguese nurses. Data were subjected to lexicographic analysis with the support of the interface IRaMuTeQ-R. Results: 269 text segments were analyzed, retaining 84.86% of the total in 4 classes: interactions between professionals and men, therapeutic itineraries, “talking” about sexual health, and men’s access to sexual health care. Similarity analysis led to 3 central cores: problem, saying, and patient. Conclusions: The training of professionals in men’s sexual health to demystify stereotypes about masculinity is fundamental. At the organizational level, it is necessary to analyze the possibilities of access and its visibility in electronic records and rethink the planning and provision of primary and differentiated care.

AbstractThe Asian Hornet (Vespa velutina) is an invasive species that causes severely negative impacts on the ecosystems’ functioning, human health and agriculture. Its impact extends to the detriment of orchards and vineyards as the species feeds on fruits to obtain sugar, consequently diminishing the marketable yield and reducing the overall quantity of final products. The survey presented in this manuscript aimed to study the agricultural technicians’ appraisal of fruit damage caused by V. velutina since its appearance in the western coast of the Iberian Peninsula. In Galicia, Spain, 83% of technicians reported incidents on fruit damage, primarily affecting grapes, but also on pears and apples. In Portugal, 25% of technicians reported similar occurrences covering 8 species of fruit, notably on grapes, but also on apples, pears, figs, plums, peaches, blueberries and blackberries. This outcome showcases how V. velutina may cause non-negligible, direct detriment to fruit production, particularly to grapes. More studies are needed to quantify the economic impact of this type of damage.

Giant cell arteritis (GCA) may manifest with aggressive intracranial stenosis resistant to medical therapy, and patients may develop refractory neurologic deficits and cerebral infarcts, making GCA a life-threatening condition. We report the case of a 68-year-old woman recently diagnosed with GCA, medicated with prednisolone 60 mg daily. Two weeks later, the patient was admitted to our Stroke Unit after a sudden episode of global aphasia. Magnetic resonance angiography showed two recent ischaemic lesions, besides an erythrocyte sedimentation rate of 17 mm/hour. A cerebral angiography revealed bilateral stenosis and dilation in the petrous, cavernous and supraclinoid segments of internal carotid arteries (ICA). The patient was started on intravenous methylprednisolone pulses (250 mg daily for five days). Computed tomography (CT) angiography and Doppler ultrasound showed severe vascular disease affecting multiple territories, without significant intracranial involvement. The hypothesis of GCA with extracranial vasculitic involvement was considered as the aetiology of ischaemic cerebral infarctions in multiple territories and, given the severity of the disease, it was decided to add tocilizumab. Despite this, the patient evolved with significant worsening neurological deficits and a CT scan confirmed the presence of new vascular events. Endovascular treatment (EVT) with balloon angioplasty was conducted on both ICAs, with improved calibre and downstream filling. After that, the patient presented sustained clinical improvement, without recurrence of any ischaemic events at the one-year follow-up. This clinical case stands out for the importance of EVT as an effective therapy in patients with medically refractory GCA with symptomatic intracranial stenosis, improving their prognosis.

Introdução: As representações sociais sobre o que é saúde sexual são produzidas, transformadas e reconfiguradas quotidianamente pela ação dos indivíduos, pelas suas experiências nas relações com os outros, e pelas interações sociais em diversos contextos mediados por normas e papéis sociais (Moscovici, 1984; Herzlich, 1992; Jodelet, 1989). Os universos simbólicos dos enfermeiros traduzem-se em mapas de significação e idealização normativa, que estruturam as suas práticas e influenciam o acesso dos homens aos cuidados de saúde sexual. Objetivo: Analisar as representações sociais dos enfermeiros sobre saúde sexual dos homens considerando as possibilidades e os constrangimentos destes no acesso aos cuidados de saúde através da utilização do IRaMuTeQ. Material e Métodos: Estudo qualitativo e descritivo com a realização de um Focus Group online (Morgan, 2019). Na procura de heterogeneidade no grupo de participantes, foram convidados 5 enfermeiras e 4 enfermeiros portugueses com diferentes tempos de exercício profissional nos cuidados de saúde primários e diferentes tipos de serviços dos cuidados de saúde diferenciados. A entrevista de grupo foi transcrita e preparada em corpus textual para a análise lexicográfica, com recurso ao IRaMuTeQ - Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires, um software gratuito, com fonte aberta para análise de dados textuais (Camargo & Justo, 2013; 2018). Foi solicitado parecer ao Conselho de Ética da ESEL e foi obtido o consentimento informado de todos os participantes. Resultados: Análise de 269 segmentos de texto, retendo 84,86% do total para 4 classes: interações entre os profissionais e os homens, itinerários terapêuticos, “falar” sobre saúde sexual e acesso dos homens aos cuidados de saúde sexual. A análise de similitude originou 3 núcleos centrais: problema, dizer e doente. Conclusões: Possibilitar o acesso dos homens aos cuidados de saúde sexual, requer o planeamento e a realização de formação dos profissionais em saúde sexual em geral e sobre os homens em particular. Requer, ainda, uma abordagem positiva da saúde sexual e uma convergência de esforços das políticas de saúde, das instituições formativas, dos investigadores, dos profissionais de saúde e das comunidades em geral para desmistificar crenças e estereótipos sobre a sexualidade, a masculinidade e clarificar a inclusão dos homens como sujeitos de cuidados.

Salt marshes play a critical role in supporting water quality, erosion control, flood protection, and carbon sequestration. Threats from climate change and human activities have prompted global restoration initiatives. We analyzed restoration efforts worldwide from 1978 to 2022, using the Web of Science database and SciMAT mapping tool. After a PRISMA screening to identify methodologies, success rates, and key indicators, a total of 62 publications underwent detailed analysis, to increase knowledge on the best practices to employ in future restoration interventions and evaluation of their effectiveness. The research reveals a growing interest in ecosystem dynamics, biodiversity, anthropogenic impacts, and ecosystem services. Assisted interventions emerged as the predominant restoration method, employing 15 indicators across vegetation, sediment, fauna, and water, each one using different metrics for the intervention evaluation based on how good the outcome of the interventions described in the reviewed studies met the desired result. Our analysis suggests that combining natural interventions such as managed realignment with reconnection to tidal waters, along with long-term monitoring of vegetation, fauna, and water indicators such as sedimentation and erosion rates, plant cover and biomass, as well as fauna diversity and density, leads to the most successful outcomes. We provide valuable insights into best practices for future restoration interventions, offering guidance to future practitioners and policymakers based on a comprehensive review of the scientific literature, contributing to the resilience of these vital ecosystems, and ensuring effective restoration actions in the coming years.

A steady supply of mineral raw materials is vital for the transition to a low-carbon, circular economy. The number of active mines in Europe has severely declined over the last century and half, giving rise to many abandoned mining waste sites and corresponding geological heritage. Also, the rise in minerals demand for large-scale deployment of renewable energy requires the continued and steady availability of key minerals. The supply risk associated with unpredicted geopolitical events needs to be eliminated/mitigated. Historical mine waste sites are the answer but evaluating mine waste is a lengthy and costly exercise. The study, undertaken in the Lousal Mine, used small unmanned aerial systems (sUASs) to model and determine mine waste volumes by generating orthomosaic maps with quick, inexpensive, and reliable results. Calculated mine waste volumes between 308,478 m3 and 322,455 m3 were obtained. XRD and p-XRF techniques determined the mineralogy and chemistry of waste, which varied from mineralization and host rocks with hydrothermal alteration and numerous neogenic sulphates (mostly gypsum, rhomboclase, ferricopiapite, coquimbite, and jarosite) related with supergene processes and weathering. The study shows the viability of using these sUASs to successfully model historical mine waste sites in an initial phase and for future monitoring programs.

O Centro para Controlo e Prevenção de Doenças propõe o termo COVID longo ou condições pós-COVID para sintomas desenvolvidos durante ou após a COVID-19 e que persistem pelo menos dois meses, não sendo explicados por outros diagnósticos. Este estudo transversal tem como objetivo determinar a proporção de doentes com condições pós-COVID, descrevendo as suas características demográficas e clínicas e sintomas persistentes mais comuns. Foram incluídos 497 adultos com doença ligeira a moderada por COVID-19, avaliados por questionário estruturado após 12 a 16 semanas da infeção por SARS-CoV-2. A incidência cumulativa de condições pós-COVID foi de 47,5% (n=236). Os sintomas persistentes mais frequentes foram a astenia (n=151, 30,4%) e a dispneia (n=131, 26,4%). Após análise multivariada verificou-se que o sexo masculino está associado a menor incidência de condições pós-COVID (OR=0,36, p

Recent awareness of the viability and benefits of incremental hemodialysis is an opportunity to review clinical practices and improve the process of dialysis induction. Incremental dialysis is a standard approach in peritoneal dialysis prescription, with a focus on the quality parameter of nephroprotection. The same should apply in hemodialysis, with individualization of the prescribed extracorporeal technique: frequency, duration and intensity, in either home or center hemodialysis, are prescription variables to adjust according to the patient’s residual renal function, medical condition and psycho-social priorities. Considering that fluid balance and smooth ultrafiltration critically impact patient survival, incremental dialysis schedules need to be carefully tailored and grounded in routine residual kidney function measurement. This paper raises concerns about both the benefits of incremental dialysis and its putative detrimental effects, these being mainly dependent on the quality of the hemodialysis prescription and external economic constraints. As a comparator, incremental peritoneal dialysis is a scientifically based model to pursue, whichever the modality, based on updated concepts of patient-centered prescription and adequacy in dialytic renal replacement therapies.

Natural and sustainable anti-aging ingredients have gained attention from the cosmetic industry. This study evaluated the anti-aging potential of a sugarcane straw extract-based (SSE) cosmetic ingredient. First, cytotoxicity tests were assessed in keratinocytes and fibroblast cell lines, and sensitization was carried out through the direct peptide reactivity assay. Subsequently, various anti-aging properties were investigated, including inhibiting skin aging-related enzymes, promoting elastin and hyaluronic acid synthesis, and anti-pollution activity. Finally, a permeability assay using a synthetic membrane resembling skin was conducted. The results demonstrated that the SSE ingredient effectively inhibited elastase (55%), collagenase (25%), and tyrosinase (47%) while promoting hyaluronic acid production at non-cytotoxic and low-sensitizer concentrations. Moreover, it reduced the inflammatory response provoked by urban pollution, as evidenced by decreased levels of IL1-α and IL-6. However, it was observed that the phenolic compounds predominantly reached the skin’s surface, indicating a limited ability to penetrate deeper layers of the skin. Therefore, it can be concluded that the SSE ingredient holds anti-aging properties, albeit with limited penetration into deeper skin layers. Further research and formulation advancements are needed to optimize the ingredient’s ability to reach and exert its effects in deeper skin layers.

RESUMO Objetivo: Avaliar a qualidade de vida relacionada com a saúde e a incapacidade no primeiro mês após a alta para domicílio de todos os sobreviventes de COVID-19 grave internados por mais de 24 horas no Serviço de Medicina Intensiva. Metódos: Estudo realizado no Serviço de Medicina Intensiva do Centro Hospitalar Universitário São João, entre 8 de outubro de 2020 e 16 de fevereiro de 2021. Aproximadamente 1 mês após a alta para domicílio, uma enfermeira com experiência em medicina intensiva realizou uma consulta telefônica a 99 sobreviventes, aplicando os questionários EuroQol Five-Dimensional Five-Level e World Health Disability Assessment Schedule 2.0 - 12 itens. Resultados: A média de idade da população estudada foi de 63 ± 12 anos, e 32,5% foram submetidos à ventilação mecânica invasiva. O Simplified Acute Physiology Score médio foi de 35 ± 14, e o Índice de Comorbilidades de Charlson foi de 3 ± 2. O tempo de internamento em medicina intensiva e no hospital foi de 13 ± 22 e 22 ± 25 dias, respectivamente. A média da Escala Visual Analógica da EuroQol foi de 65% (± 21), sendo que apenas 35,3% dos sobreviventes não apresentaram ou tiveram problemas ligeiros para realizar suas atividades habituais, a maioria com algum grau de dor/desconforto e ansiedade/depressão. O World Health Disability Assessment Schedule 2.0 - 12 itens, mostrou incapacidade marcada em retomar o trabalho habitual ou atividades comunitárias e na mobilidade. O uso de ambas as ferramentas sugeriu que o estado de saúde dos sobreviventes seria pior do que a sua percepção. Conclusão: A identificação precoce de sequelas pode ajudar a definir fluxos e prioridades para a reabilitação e reinserção após a COVID-19 grave.

Este artigo faz uma reflexão sobre o trabalho e o registro pictórico dos artistas integrantes das expedições científicas procurando esclarecer algumas das indagações quanto à fidelidade dessas produções diante das observações da natureza e dos costumes brasileiros, e revelar outra possibilidade de leitura de algumas obras interpretadas atualmente com um viés crítico ambiental. Apesar de muitos visitantes estrangeiros apresentarem obras sobre as terras brasileiras, limitamo-nos a mencionar Nicolas-Antoine Taunay e Jean-Baptiste Debret, membros da Missão Artística Francesa e fundadores da Academia Imperial de Belas Artes para fomentar a discussão quanto à fidelidade desses registros. Também descreveremos um comparativo entre Johann Moritz Rugendas e Hercule Florence por fazerem parte da Expedição de Langsdorff, e produzirem obras que evidenciam olhares, técnicas e concepções artísticas diferentes. Por fim apresentaremos interpretações do embate entre humano e natureza na obra de Manuel Araújo Porto Alegre e da denúncia e defesa ambiental na obra de Félix Taunay.

Introduction: Endoscopic retrograde cholangiopancreatography (ERCP) in patients with Billroth II gastrectomy is still a challenging procedure. The optimal approach, namely the type of endoscope and sphincter management, has yet to be defined. Aim: To compare the efficacy and safety of forward-viewing gastroscope and the side-viewing duodenoscope in ERCP of patients with Billroth II gastrectomy. Methods: We conducted a retrospective, single-center cohort study of consecutive patients with Billroth II gastrectomy submitted to ERCP in an expert center for ERCP between 2005 and 2021. The outcomes assessed were: papilla identification, deep biliary cannulation, and adverse events (AEs). Multivariate analysis was performed to evaluate potential associations and predictors of the main outcomes. Results: We included 83 patients with a median age of 73 (IQR 65–81) years. ERCP was performed using side-viewing duodenoscope in 52 and forward-viewing gastroscope in 31 patients. Patients’ characteristics were similar in the two groups. The global rate of papilla identification was 66% (n = 55). The rate of deep cannulation was 58% considering all patients and 87% in the subgroup of patients in which the papilla major was identified. Cannulation was performed with standard methods in 65% of cases and with needle-knife fistulotomy in 35%. AEs occurred in 4 patients. There was no difference between duodenoscope and gastroscope in papilla identification (64% [95% CI: 51–77] vs. 71% [55–87]). Although not statistically significant, duodenoscope had a lower deep cannulation rate when considering all patients (52% [15–39] vs. 68% [7–35]) and a higher AEs rate (8% [1–15] vs. 0% [0–1]). In a multivariate analysis, the use of gastroscope significantly increased the deep cannulation rate (OR = 152.62 [2.5–9,283.6]). Conclusion: This study demonstrates that forward-viewing gastroscope is at least as effective and safe as side-viewing duodenoscope for ERCP in patients with Billroth II gastrectomy. Moreover, our study showed that gastroscope is an independent predictor of successful cannulation.

Background and Aims: Nonalcoholic steatohepatitis (NASH) is associated with increased mortality and risk of complications but is often asymptomatic and under-recognized. A systematic review of NASH epidemiology was conducted to provide information on the burden of NASH and highlight important evidence gaps for future research. Methods: Medline, EMBASE, and Cochrane Library databases were searched for English-language publications published from 2010 to January 2022 that reported on natural history, risk factors, comorbidities, and complications of a NASH population or subpopulation. Results: Overall, 173 publications were included. NASH was shown to have a variable disease course and high prevalence of comorbid disease. Although many patients progressed to cirrhosis and end-stage liver disease, disease regression or resolution was reported in up to half of patients in some studies. Reported risk factors for disease progression or resolution included levels of (or changes in) serum fibrosis markers, liver enzymes, and platelets. The presence of NASH increased the risk of liver cirrhosis and other serious diseases such as hepatocellular carcinoma, colorectal cancer, chronic kidney disease, and cardiovascular disease. In 2017, NASH was responsible for ∼118,000 cirrhosis deaths globally, and an increasing proportion of patients are receiving liver transplantation for NASH in Europe and the United States. Consolidation of data was hampered by heterogeneity across the studies in terms of patient populations, follow-up time, and outcomes measured. Conclusion: NASH is associated with significant morbidity and mortality, an increased risk of comorbidities, and imposes an increasing burden among liver transplantation recipients. Longer studies with harmonized study criteria are required to better understand the impact of NASH on patient outcomes.

ARCHIVER and Pre-Commercial Procurement funding has enabled small to medium enterprises (SMEs) to innovate and deliver new services for EOSC. Within the framework of the ARCHIVER pre-commercial procurement tender, between December 2020 and August 2021, three commercial consortia competed to deliver innovative, prototype solutions for long-term data preservation. Two of them were selected to continue with the pilot phase and deliver research-ready solutions for long-term data preservation of research data, therefore filling a gap in the current European Open Science panorama. Digital preservation relies on technological infrastructure (information and communication technology, ICT) that can have environmental impacts. While altering technology usage can reduce the impact of digital preservation practices, this alone is not a strategy for sustainable practice. Moving toward environmentally sustainable digital preservation requires critically examining the motivations and assumptions that shape current practice. The use of scalable cloud infrastructures can reduce the environmental impacts of long-term data preservation solutions.

Abstract European Society of Gastrointestinal Endoscopy recommends needle-knife fistulotomy (NKF) as the preferred precut technique. However, there is little information on whether NKF performed at different times is associated with different success and adverse event rates. We compared the outcomes of 3 different timings of NKF. This was an observational study conducted at 4 institutions and this was a retrospective analysis of prospectively collected data. We included 330 consecutive patients submitted to NKF attempt for biliary access. Patients were divided into three groups: NKF as an initial procedure for biliary access (group A, n = 121); early NKF defined as after 5 min, 5 attempts, or 2 pancreatic passages (group B, n = 99); and late NKF: after at least 10 min of unsuccessful standard biliary cannulation (group C, n = 110). We assessed the success rate of biliary cannulation at initial ERCP, time to perform NKF until biliary cannulation, overall biliary cannulation rate (second ERCP when initial failure), adverse event rate, and predictors of post-ERCP pancreatitis (PEP). The initial cannulation rate was 98%, 91% and 94% for groups A, B and C respectively, p = 0.08, whereas overall biliary cannulation rate was 100%, 95% and 98%, p = 0.115. The adverse event rate/PEP was 4.1%/2.5%, 7.1%/4% and 10.9%/8.2%, for groups A, B and C respectively, (p = 0.197 and p = 0.190). Median time for creating the fistula was A = 4.0 min, B = 3.2 min, and C = 5.6 min, p

Background & Aims: Non-alcoholic steatohepatitis (NASH) is associated with increased mortality and a high clinical burden. NASH adversely impacts patients’ health-related quality of life (HRQoL), but published data on the humanistic burden of disease are limited. This review aimed to summarise and critically evaluate studies reporting HRQoL or patient-reported outcomes (PROs) in populations with NASH and identify key gaps for further research. Methods: Medline, EMBASE, the Cochrane Library and PsycINFO were searched for English-language publications published from 2010 to 2021 that reported HRQoL/PRO outcomes of a population or subpopulation with NASH. Results: Twenty-five publications covering 23 unique studies were identified. Overall, the data showed a substantial impact of NASH on HRQoL, particularly in terms of physical functioning and fatigue, with deterioration of physical and mental health as NASH progresses. Prevalent symptoms, including fatigue, abdominal pain, anxiety/depression, cognition problems, and poor sleep quality, adversely impact patients’ ability to work and perform activities of daily living and the quality of relationships. However, some patients fail to attribute symptoms to their disease because of a lack of patient awareness and education. NASH is associated with high rates of comorbidities such as obesity and type 2 diabetes, which contribute to reduced HRQoL. Studies were heterogeneous in terms of diagnostic methods, population, outcomes, follow-up time, and measures of HRQoL/utility. Most studies were rated ‘moderate’ at quality assessment, and all evaluable studies had inadequate control of confounders. Conclusions: NASH is associated with a significant HRQoL burden that begins early in the disease course and increases with disease progression. More robust studies are needed to better understand the humanistic burden of NASH, with adequate adjustment for confounders that could influence outcomes. Lay summary: Non-alcoholic steatohepatitis (NASH) has a significant impact on quality of life, with individuals experiencing worse physical and mental health compared with the general population. NASH and its symptoms, which include tiredness, stomach pain, anxiety, depression, poor focus and memory, and impaired sleep, affect individuals’ relationships and ability to work and perform day-to-day tasks. However, not all patients are aware that their symptoms may be related to NASH. Patients would benefit from more education on their disease, and the importance of good social networks for patient health and well-being should be reinforced. More studies are needed to better understand the patient burden of NASH.

As características da dança, como atividade humana natural e vinculada a determinada cultura, são essenciais para encararmos as funções e o contexto nos quais as práticas de aprendizagem na licenciatura em dança estão inseridas, nomeadamente ao nível das metodologias de ensino da dança. Neste artigo procedemos a uma fundamentação teórica das atividades que preconizamos com os nossos estudantes-professores na unidade curricular de Metodologia do Ensino da Dança, pertencente ao 3º ano da licenciatura em dança na Faculdade de Motricidade Humana, Universidade de Lisboa. De modo genérico, propomos aos estudantes a consolidação e a amplificação do repertório de comportamento de ensino e o desenvolvimento, a implementação e a avaliação do seu projeto de ensino-aprendizagem de dança. Usando uma abordagem focada em oferecer enquadramento e espaço de aplicação de práticas com diferentes métodos, estilos e estratégias de ensino em diferenciados contextos educativos, a unidade curricular procura uma articulação criteriosa dos variados constructos teóricos, mediando os estudantes a capacitarem-se com um poder crítico e a conhecer quem vai adquirir o quê e de que forma, como propõe Pinto (2011). Explicitamos processos de construção de curricula, explanando princípios de atuação que preconizamos como relevantes ao exercício da função docente, especificando competências dos estudantes-professores e vinculando-nos à teoria do ciclo de aprendizagem experiencial (KOLB, 1984) ao propor uma atuação dinâmica entre planificação - intervenção - controlo - avaliação - reformulação da atividade pedagógica. Palavras-chave Ensino de Dança. Metodologias de Ensino. Planificação. Prática Pedagógica. Ensino Superior Português.

Abstract Background Existing proposed classification systems for the Papilla of Vater (PV) suboptimally account for all relevant, encountered PV appearances, are too complex or have not been assessed for intra- or interobserver variability. We proposed a novel endoscopic classification system for PV, determined its inter- and intraobserver rates and used the classification system to assess whether the success and complications of needle-knife fistulotomy (NKF) are influenced by the morphology of the PV. Methods The classification system was developed by expert endoscopists. To evaluate the inter- and intraobserver agreement, an online questionnaire was sent to 20 endoscopists from several countries (10 experts and 10 nonexperts) that included 50 images of papillae of Vater divided among various categories. Four weeks later, a second survey, with the images from the first questionnaire randomly reordered, was sent to the same endoscopists. The inter- and intraobserver agreements among the experts and nonexperts was calculated. Using the proposed classification system, all 361 consecutive patients who underwent NKF for biliary access to a naïve papilla were prospectively enrolled in the study. Results The novel classification system comprises 7 categories: type I, flat type, lacking an oral protrusion; type IIA, prominent tubular nonpleated type, with an oral protrusion and 2 transverse folds over the oral protrusion; type IIC: prominent bulging type, with an enlarged and bulging oral protrusion; type IIIA, diverticular-intradiverticular type, with a papillary orifice inside the diverticulum; type IIIB: diverticular-diverticular border type, with a papillary orifice less than 2 cm from the diverticular border; type IV: unclassified papilla, with no morphology classified in the other categories. The interobserver agreement between experts was substantial (K = 0.611, 95% CI 0.498–0.709) and was higher than that between nonexperts (K = 0.516; 95% CI 0.410–0.636). The intraobserver agreement was substantial among both experts (K = 0,651; 95% CI 0.586–0.715) and nonexperts (K = 0.646, 95% CI 0.615–0.677). In a multivariate model, type IIIA and IIIB were the only independent risk factors for difficult rescue NKF biliary cannulation (P = 0.003 and P = 0.019, respectively), and type I and type IIB were the only independent risk factors for a prolonged cannulation time using NKF (P

The liquid phase exfoliation (LPE) of graphite has allowed to produce graphene materials on a large scale and at a reasonable cost. By this method, stable dispersions, inks and liquid suspensions containing atomic-thick graphene flakes with tailored concentrations can be produced, opening up applications in a wide range of cutting-edge technologies such as functional coatings, printed and flexible electronics, and composites. However, currently established LPE techniques raise several health and environmental risks, since unsafe and toxic solvents (such as NMP, DMF, and DMSO) are often regarded as the most effective liquid media for the process. Therefore, it appears necessary to unlock eco-friendly and sustainable methods for the production of graphene at an industrial scale. This review focuses on the latest developments in terms of green solvents for LPE production of graphene. We highlight the use of a new green solvent, Cyrene, and its performance when compared to conventional solvents.

This article aims to analyze two biographical films of Stephen Hawking in order to identify the representations of the scientist present in cinematographic works. For this, the investigation was based on film analysis and categorization following the main representations identified in the literature. The analysis identified the most common representations present in the scenes and sequences in which the protagonist acted, taking into account the context for certain actions of the scientist. The results indicated that the analyzed works, which belong to a biographical genre, are also bound to permeate stereotypes that contribute to a distorted view of the scientist and scientific work, just as it happens in other cinematic genres.

Este artigo tem como objetivo analisar dois filmes biográficos de Stephen Hawking com o intuito de identificar as representações do cientista presentes em obras cinematográficas. Para isso, a investigação contou com a análise fílmica e os filmes foram categorizados seguindo as principais representações identificadas pela literatura. A análise identificou as representações mais comuns presentes nas cenas e sequências em que o protagonista atuou, levando em consideração o contexto de determinadas ações do cientista. A representação de gênio foi a mais evidente nos dois filmes. Os resultados indicaram que as obras analisadas, de gênero biográfico, também estão fadadas a permear estereótipos que contribuem com uma visão deturpada do cientista e do labor científico, assim como acontece em outros gêneros cinematográficos.

Cannabidiol (CBD) and cannabigerol (CBG) are two pharmacologically active phytocannabinoids of Cannabis sativa L. Their antimicrobial activity needs further elucidation, particularly for CBG, as reports on this cannabinoid are scarce. We investigated CBD and CBG’s antimicrobial potential, including their ability to inhibit the formation and cause the removal of biofilms. Our results demonstrate that both molecules present activity against planktonic bacteria and biofilms, with both cannabinoids removing mature biofilms at concentrations below the determined minimum inhibitory concentrations. We report for the first time minimum inhibitory and lethal concentrations for Pseudomonas aeruginosa and Escherichia coli (ranging from 400 to 3180 µM), as well as the ability of cannabinoids to inhibit Staphylococci adhesion to keratinocytes, with CBG demonstrating higher activity than CBD. The value of these molecules as preservative ingredients for cosmetics was also assayed, with CBG meeting the USP 51 challenge test criteria for antimicrobial effectiveness. Further, the exact formulation showed no negative impact on skin microbiota. Our results suggest that phytocannabinoids can be promising topical antimicrobial agents when searching for novel therapeutic candidates for different skin conditions. Additional research is needed to clarify phytocannabinoids’ mechanisms of action, aiming to develop practical applications in dermatological use.

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Introduction: Heart failure is a disease with survival estimates of around 10% after 10 years of the disease. Being a chronic and debilitatingillness, it is important to investigate the potential efficacy of a palliative care approach for these patients. The aim of this study is to systematically review the efficacy of integrating palliative care in patients with advanced heart failure, including the outcomes overall quality of life and well-being, overall symptom burden and possible specific symptoms, hospital admission rates and mortality. Material and Methods: The MEDLINE, Cochrane, EMBASE and CINAHL databases were searched for articles published between January 2010 and December 2020 about palliative care interventions in patients with heart failure. Clinical studies with humans with symptomatic heart failure were included, comparing the integration of palliative care with usual cardiac care. Results: The search protocol resulted in seven eligible studies for review and qualitative synthesis. The overall risk of bias within studies was moderate to high. Most studies demonstrated improvements with the integration of palliative care in terms of quality of life and reduction of admission rates. The evidence to support a significant improvement in overall symptom burden was not so robust among studies. Conclusion: Palliative care interventions seem, overall, to be significantly effective in patients with heart failure. Future studies with more rigorous study designs are needed, in order, to further develop the role of palliative care in heart failure patients.

Evasion and retention are problems surrounding physics courses throughout Brazil. In this article, we present the results of an investigation that proposed to raise some of the reasons related to these phenomena. For this, interviews were made with students and teachers of the Licentiateship and Bachelor of Physics courses of Universidade Federal de Ouro Preto. For the study of this problem we assume Bourdieu’s Theory of the Education System, highlighting the various relationships of dominance that exist in the courses, which contributes to the high evasion and retention in this analysed University. Among the conclusions reached, after the analytical procedures of the investigative corpus, that is, the collected reports, we highlight: for the students these motives focus on the “complicated” personal relations with the teachers and the “accelerated” routine in the republics where they reside; For teachers, the main factor is related to the use of the Physics course as a “trampoline” for other courses, mainly Engineering.

Mapping of ecosystem services (ES) is a powerful tool for communication and knowledge sharing about the implications of ecosystem management practices for human wellbeing. This research aimed to show the usefulness of ES mapping for decision-making by combining modelling of ES supply with ES demand mapping in a participatory process with the engagement of relevant stakeholders. We used the ESTIMAP-pollination model to map wild bee abundance and pollination supply in the Sudoeste Alentejano and Costa Vicentina Natural Park (PNSACV) in Portugal. The model was modified by adding a behavioural component that distributes pollinator visits according to floral availability. Balancing pollination supply with crop dependency levels allowed visualising potential areas of satisfied and unsatisfied demand and testing the effectiveness of ecosystem management interventions. The discussion of these results in two participatory workshops triggered the first collective debate about pollination in the PNSACV. This engagement enabled the development of a shared understanding about this ES and highlighted the role of ES maps as tools to support collaborative natural resources management.