Interventions for dysphagia in acute stroke (Review)

Background It is unclear how dysphagic patients should be fed and treated after acute stroke. Objectives The objective of this review was to assess the effect of different management strategies for dysphagic stroke patients, in particular how and when to feed, whether to supplement nutritional intake, and how and whether to treat dysphagia. Search strategy We searched the Cochrane Stroke Group trials register, Medline, Embase, ISI, and existing review articles.We contacted researchers in the field and equipment manufacturers. Date of the most recent searches: March 1999. Selection criteria Unconfounded truly or quasi randomised controlled trials in dysphagic patients with acute/subacute (within 3 months) stroke. Data collection and analysis Three reviewers independently applied the trial inclusion criteria. Two reviewers assessed trial quality and extracted the data. Main results Percutaneous endoscopic gastrostomy (PEG) versus nasogastric tube (NGT) feeding: two trials (49 patients) suggest that PEG reduces end-of-trial case fatality (Peto Odds Ratio, OR 0.28, 95% CI 0.09 to 0.89) and treatment failures (OR 0.10, 95% CI 0.02 to 0.52), and improves nutritional status, assessed as weight (Weighted Men Difference, WMD +4.1 kg, 95% CI -4.3 to +12.5), mid-arm circumference (WMD +2.2 cm, 95% CI -0.5 to +4.9) or serum albumin (WMD + 7.0 g/l, 95% CI +4.9 to +9.1) as compared with NGT feeding; two larger studies are ongoing. Timing of feeding: no completed trials; one large study is ongoing. Swallowing therapy for dysphagia: two trials (85 patients) suggest that formal swallowing therapy does not significantly reduce end-of-trial dysphagia rates (OR 0.55, 95%CI 0.18 to 1.66). Drug therapy for dysphagia: one trial (17 patients); nifedipine did not alter end-of-trial case fatality or the frequency of dysphagia. Nutritional supplementation: one trial (42 patients) found a non-significant trend to a lower case fatality, and significantly increased energy and protein intake; one large trial is ongoing and data is awaited from two other studies. Fluid supplementation: one trial (20 patients) found that supplementation did not alter the time to resolution of dysphagia. Authors’ conclusions Too few studies have been performed, and these have involved too few patients. PEG feeding may improve outcome and nutrition as compared with NGT feeding. Further research is required to assess how and when patients are fed, and the effect of swallowing or drug therapy on dysphagia.

Habitat selection and phenotypic diversity in the anchovy of the Bay of Biscay

Diversity among individuals in a population is an important feature linking vital rates with behaviour and spatial occupation. We measured the growth increments in the otolith of individual fishes collected on the annual fisheries survey PELGAS from 2001 to 2015. Individuals who grew larger at juvenile stage occupied later in life more off-shore habitats. Further, we analysed the allozymes of 13 different loci from 2001 to 2006. Alleles of the enzyme IDH showed different frequencies in inshore and offshore habitats. The population spatially segregates along a coast to off-shore gradient with individuals showing different early growth and allele frequencies. Results show how individuals in a population segregate spatially in different habitats in relation with phenotypic diversity. This implies modelling the population with individual-based and physiological approaches to fully grasp its dynamics. It also implies developing management strategies to conserve infra-population diversity as a means to garantee the occupation of the full range of habitats.

Effects of dredging operations on sediment quality: contaminant mobilization in dredged sediments from the Port of Santos, SP, Brazil

Background, aim, and scope Contaminated sediments are a worldwide problem, and mobilization of contaminants is one of the most critical issues in environmental risk assessment insofar as dredging projects are concerned. The investigation of how toxic compounds are mobilized during dredging operations in the channel of the Port of Santos, Brazil, was conducted in an attempt to assess changes in the bioavailability and toxicity of these contaminants.Materials and methods Bulk sediment samples and their interstitial waters and elutriates were subjected to chemical evaluation and ecotoxicological assessment. Samples were collected from the channel before dredging, from the dredge's hopper, and from the disposal site and its surroundings.Results The results indicate that the bulk sediments from the dredging site are contaminated moderately with As, Pb, and Zn and severely with Hg, and that polycyclic aromatic hydrocarbon (PAH) concentrations are relatively high. Our results also show a 50% increase in PAH concentrations in suspended solids in the water collected from the hopper dredge. This finding is of great concern, since it refers to the dredge overflow water which is pumped back into the ecosystem. Acute toxicity tests on bulk sediment using the amphipod Tiburonella viscana showed no toxicity, while chronic tests with the sea urchin Lytechinus variegatus showed toxicity in the interstitial waters and elutriates. Results are compared with widely used sediment quality guidelines and with a sediment quality assessment scheme based on various lines of evidence.Conclusions The data presented here indicate that the sediments collected in this port show a certain degree of contamination, especially those from the inner part of the channel. The classification established in this study indicated that sediments from the dredged channel are impacted detrimentally and that sea disposal may disperse contaminants. According to this classification, the sediments are inappropriate for disposal at sea. It should be emphasized that the poor quality of fine sediments discharged from the hopper dredge in the overflow process can recontaminate the environment.Recommendations and perspectives These findings will help to underpin improved planning of management strategies for dredging operations and sediment disposal in Brazil and other countries.

UNDERSTANDING LATE SEASON FRUIT ROT PATHOSYSTEMS AND INSECT INTERACTIONS IN MID-ATLANTIC VINEYARDS

Fungal fruit rots and insect pests are among the most important problems negatively affecting the yield and quality of mid-Atlantic wine. In pathogenicity trials of fungi recovered from diseased Chardonnay and Vidal blanc grapes, Alternaria alternata, Pestalotiopsis telopeae, and Aspergillus japonicus were found to be unreported fruit rot pathogens in the region. Additionally, P. telopeae and A. japonicus had comparable virulence to the region’s common fruit rot pathogens. Furthermore, a timed-exclusion field study was implemented to evaluate vineyard insect-fruit rot relationships. It was found that clusters exposed to early-season insect communities that included Paralobesia viteana had a significantly greater incidence of sour rot than clusters protected from insects all season. These results were contrary to the current assumption that fall insects are the primary drivers of sour rot in the region. This research provides diagnostic tools and information to develop management-strategies against fungal and insect pests for mid-Atlantic grape growers.

Estudo do recuo das arribas a leste de Quarteira (Algarve-Portugal) por restituiçäo fotogramétrica

Dissertação de mest. em Estudos Marinhos e Costeiros Ramo Gestão Costeira, Unidade de Ciências e Tecnologias dos Recursos Aquáticos, Univ. do Algarve, 1996

Avaliação do desempenho segundo a metodologia do balanced scorecard: aplicação à gestão hospitalar no Algarve

Dissertação de mest. em Gestão Empresarial, Faculdade de Economia, Univ. do Algarve, 2004

An expert model approach to assess the potential of non-wood forest products for forest owners

Mestrado em Engenharia Florestal e dos Recursos Naturais - Instituto Superior de Agronomia - UL

Spatial distribution patterns and movements of Holothuria arguinensis in the Ria Formosa (Portugal)

Holothurian populations are under pressure worldwide because of increasing demand for beche-de-mer, mainly for Asian consumption. Importations to this area from new temperate fishing grounds provide economic opportunities but also raise concerns regarding future over-exploitation. Studies on the habitat preferences and movements of sea cucumbers are important for the management of sea cucumber stocks and sizing of no-take zones, but information on the ecology and behavior of temperate sea cucumbers is scarce. This study describes the small-scale distribution and movement patterns of Holothuria arguinensis in the intertidal zone of the Ria Formosa national park (Portugal).Mark/recapture studieswere performed to record theirmovements over time on different habitats (sand and seagrass). H. arguinensis preferred seagrass habitats and did not show a size or life stage-related spatial segregation. Its density was 563 ind. ha−1 and mean movement speed was 10 m per day. Movement speed did not differ between habitats and the direction of movement was offshore during the day and shoreward during the night. Median home range size was 35 m2 and overlap among home ranges was 84%. H. arguinensis' high abundance, close association with seagrass and easy catchability in the intertidal zone, indicate the importance of including intertidal lagoons in future studies on temperate sea cucumber ecology since those systems might require different management strategies than fully submerged habitats.

Decrecimiento y renovadas estrategias para un territorio agotado. El caso de la provincia de Alicante

Las consecuencias del último boom inmobiliario han abierto el debate alrededor del crecimiento urbano en España, especialmente en áreas con una fuerte presión turística y residencial. En este trabajo se analizan algunas de las implicaciones de la crisis financiera mundial sobre la planificación urbanística municipal, centrando el estudio en la provincia de Alicante, uno de los ámbitos que mejor ilustran el éxito y la caída del modelo inmobiliario hispano. La unidad básica de análisis la componen las figuras de planeamiento municipal y estrategias territoriales vigentes, y su traducción en suelos urbanos inconclusos. Considerando que se trata de actuaciones durmientes a la espera de un contexto económico favorable, la situación hace pensar que la burbuja inmobiliaria no estaría estallada sino tan sólo desinflada. El objetivo es reflexionar, con carácter propositivo, sobre las estrategias de gestión del territorio que emergen durante los últimos años a raíz de la crisis financiera e inmobiliaria, tratando de relanzar algunas cuestiones que deberían preocupar en la planificación urbanística y territorial de la provincia de Alicante, y por extensión, de otros espacios afectados por el crash inmobiliario.

Asian soybean rust in Brazil: past, present, and future.

ABSTRACT: Asian soybean rust, caused by the fungus Phakopsora pachyrhizi, is the most severe disease of the crop and can cause yield losses of up to 90%. The disease was first reported in Brazil in 2001. Epidemics of the disease are common in the country, where the fungus can survive year?round. Regulatory measures to reduce the inoculum between seasons and avoid late-season soybean have been adopted to manage the disease. Disease control has relied mainly on chemical control, but a lower sensibility of the fungus to fungicides has been reported in Brazil. Major?resistance genes have been mapped and incorporated into the cultivars. With the reduced efficacy of the fungicides, the adoption of integrated measures to control the disease will be important for the sustainability of the crop. This review presents the main changes in the soybean crop system caused by the introduction of the fungus in Brazil, the current management strategies adopted to avoid losses, and the new trends that, together with biotechnological strategies, can improve management in the future. RESUMO: A ferrugem?asiática da soja, causada pelo fungo Phakopsora pachyrhizi, é a doença mais severa da cultura e pode causar perdas de produtividade de até 90%. A doença foi relatada pela primeira vez no Brasil em 2001. Epidemias da doença são comuns no País, onde o fungo pode sobreviver durante todo o ano. Medidas regulatórias para reduzir o inóculo entre safras e evitar a semeadura tardia de soja têm sido adotadas para manejar a doença. O controle da doença tem se baseado principalmente no controle químico, mas uma menor sensibilidade do fungo aos fungicidas tem sido relatada no Brasil. Genes de resistência têm sido mapeados e incorporados às cultivares. Por causa da redução da eficiência dos fungicidas, a adoção de medidas integradas para o controle da doença será importante para a sustentabilidade da cultura. Este artigo de revisão apresenta as principais mudanças no sistema de produção da soja causadas pela introdução do fungo no Brasil, as medidas de controle atualmente usadas para evitar perdas, e as novas tendências que, juntas com estratégias biotecnológicas, podem melhorar o manejo da doença no futuro.

Avaliação da potencial migração de Helicoverpa armigera (Lepidoptera: Noctuidae) por massas de ar para áreas produtoras de cultivos hospedeiros do Estado de São Paulo.

Resumo Helicoverpa armigera (Hübner, 1808) (Lepidoptera: Noctuidae) é um inseto exótico, altamente polífago, que foi detectado no Brasil em 2013 causando sérios danos em cultivos de soja, milho e algodão, localizados em áreas estaduais específicas das regiões Nordeste e Centro-Oeste com a presença do bioma Cerrado. Após o período de um ano o inseto foi identificado em várias regiões do País. A literatura indica que o inseto adulto apresenta características físicas que favorecem sua grande capacidade de voo, tanto em distância (100-1000 km) quanto a elevadas altitudes (maiores que 1,5 km acima do nível do solo), aumentando o seu potencial para dispersão de longo alcance, principalmente por voos migratórios das áreas já atacadas. Por essa razão, as massas de ar brasileiras podem atuar como potenciais facilitadoras à atividade migratória do inseto a longas distâncias para as áreas de maior concentração de seus cultivos hospedeiros preferenciais, resultante da atração natural do inseto aos fatores químicos delas decorrentes. Desse modo, devem ser consideradas em avaliações de áreas mais propícias à presença de H. armigera para orientar monitoramentos e estratégias de manejo locais. Este trabalho avaliou a potencial migração de H. armigera por massas de ar para áreas produtoras de cultivos hospedeiros do estado de São Paulo, considerando seus municípios produtores de algodão, soja, milho, tomate, feijão, café e laranja; as principais massas de ar brasileiras; a presença de grandes áreas com cultivos de eucalipto e pinus (outras potenciais barreiras físicas ao inseto); e a localização do bioma Cerrado paulista. Informações das áreas produtoras e das áreas plantadas por município de 2008, 2012 e 2014, disponibilizadas pelo IBGE, foram utilizadas em planos de informação georreferenciados, elaborados em ArcGis 10.3, para identificar a localização de suas respectivas grandes áreas em cada ano. O cruzamento georreferenciado também resultou mapas das áreas plantadas em 2014 com todos os cultivos citados, indicando as de maior potencial de infestação/reinfestações de H. armigera no estado de São Paulo, para orientar monitoramentos e estratégias de Manejo Integrado de Pragas - MIP locais. Abstract Helicoverpa armigera (Hübner, 1808) (Lepidoptera: Noctuidae) is an exotic insect highly polyphagous, which was detected in Brazil in 2013 causing serious damage to soybean, corn and cotton crops located in specific state areas in the northeast and center-west regions with the presence of Cerrado Biome (similar to the Savannah). After a oneyear period, the insect was detected in several regions of the country. Foreign literature indicates that the adult phase of the insect shows certain physical characteristics which favor its great flight capacity, even related to reach long distances (100-1000 Km) as many as to reach high altitudes (overtaken 1.5 Km above the ground level), increasing its potential of farthest dispersion, mainly by migratory flights from the areas already attacked. Therefore, the Brazilian air masses may act as potentially enhance the insect's farthest migratory activity to areas of greater concentration of its preferential host crops due to the insect's natural attraction to their chemical factors. Thus, migration potential of H. armigera by air masses toward preferential host crop areas must be considered in evaluations of most favorable areas to the presence of the insect to guide monitoring and local management strategies. The present work evaluated the H. armigera migration potential by air masses toward producing areas of host crops in São Paulo state, Brazil, considering its municipalities producing cotton, soybean, corn, tomato, bean, coffee, orange, eucalyptus and pine trees, as well as the main Brazilian air masses and the presence of Cerrado Biome in the state. Information of producing and of planting areas with the annual crops by municipalities in 2008, 2012 and 2014, provided by IBGE, were used in cross-maps made using ArcGis 10.3, in order to identify the location of their respective greater areas in each year. Cross-maps also provided results indicating the planting areas in 2014 with all crops already mentioned, as well as the potential areas to infestation/reinfestations of H. armigera in São Paulo State, in order to guide monitoring and local strategies of IPM.

GENETIC VARIATION, LOCAL ADAPTATION AND POPULATION STRUCTURE IN NORTH AMERICAN RED OAK SPECIES, QUERCUS RUBRA L. AND Q. ELLIPSOIDALIS E. J. HILL

Forest trees, like oaks, rely on high levels of genetic variation to adapt to varying environmental conditions. Thus, genetic variation and its distribution are important for the long-term survival and adaptability of oak populations. Climate change is projected to lead to increased drought and fire events as well as a northward migration of tree species, including oaks. Additionally, decline in oak regeneration has become increasingly concerning since it may lead to decreased gene flow and increased inbreeding levels. This will in turn lead to lowered levels of genetic diversity, negatively affecting the growth and survival of populations. At the same time, populations at the species’ distribution edge, like those in this study, could possess important stores of genetic diversity and adaptive potential, while also being vulnerable to climatic or anthropogenic changes. A survey of the level and distribution of genetic variation and identification of potentially adaptive genes is needed since adaptive genetic variation is essential for their long-term survival. Oaks possess a remarkable characteristic in that they maintain their species identity and specific environmental adaptations despite their propensity to hybridize. Thus, in the face of interspecific gene flow, some areas of the genome remain differentiated due to selection. This characteristic allows the study of local environmental adaptation through genetic variation analyses. Furthermore, using genic markers with known putative functions makes it possible to link those differentiated markers to potential adaptive traits (e.g., flowering time, drought stress tolerance). Demographic processes like gene flow and genetic drift also play an important role in how genes (including adaptive genes) are maintained or spread. These processes are influenced by disturbances, both natural and anthropogenic. An examination of how genetic variation is geographically distributed can display how these genetic processes and geographical disturbances influence genetic variation patterns. For example, the spatial clustering of closely related trees could promote inbreeding with associated negative effects (inbreeding depression), if gene flow is limited. In turn this can have negative consequences for a species’ ability to adapt to changing environmental conditions. In contrast, interspecific hybridization may also allow the transfer of genes between species that increase their adaptive potential in a changing environment. I have studied the ecologically divergent, interfertile red oaks, Quercus rubra and Q. ellipsoidalis, to identify genes with potential roles in adaptation to abiotic stress through traits such as drought tolerance and flowering time, and to assess the level and distribution of genetic variation. I found evidence for moderate gene flow between the two species and low interspecific genetic differences at most genetic markers (Lind and Gailing 2013). However, the screening of genic markers with potential roles in phenology and drought tolerance led to the identification of a CONSTANS-like (COL) gene, a candidate gene for flowering time and growth. This marker, located in the coding region of the gene, was highly differentiated between the two species in multiple geographical areas, despite interspecific gene flow, and may play a role in reproductive isolation and adaptive divergence between the two species (Lind-Riehl et al. 2014). Since climate change could result in a northward migration of trees species like oaks, this gene could be important in maintaining species identity despite increased contact zones between species (e.g., increased gene flow). Finally I examined differences in spatial genetic structure (SGS) and genetic variation between species and populations subjected to different management strategies and natural disturbances. Diverse management activities combined with various natural disturbances as well as species specific life history traits influenced SGS patterns and inbreeding levels (Lind-Riehl and Gailing submitted).

TEACHING MENSTRUAL HEALTH AND HYGIENE TO YOUNG WOMEN IN EASTERN UGANDA WITH REUSABLE MENSTRUAL PADS

In order to identify the impact of teaching menstrual health and hygiene with reusable menstrual pads on knowledge retention and school attendance, qualitative and quantitative data was collected from three rural schools in three districts of eastern Uganda: Amuria, Bukedea, and Ngora. Research techniques employed were preliminary and post surveys of 85 young women; average age 16.9 years. Findings include positive and negative results. Participants’ feelings of normalcy and comfort increased and participants had improved understanding of sexual climax and appropriate menstrual management strategies. There was no statistically significant impact of teaching on topics of sexual intercourse or pregnancy. The impact of reusable menstrual pad sanitary technology on school attendance was negative as more young women reported missing up to a full day of school during their menstrual period (χ2 (3, 73) = 7.81, p = 0.05). Study limitations are discussed and future work is suggested.

A REMOTE SENSING APPROACH TO CHARACTERIZE THE HYDROGEOLOGY OF MOUNTAINOUS AREAS: APPLICATION TO THE QUITO AQUIFER SYSTEM (QAS), ECUADOR

Climate change, intensive use, and population growth are threatening the availability of water resources. New sources of water, better knowledge of existing ones, and improved water management strategies are of paramount importance. Ground water is often considered as primary water source due to its advantages in terms of quantity, spatial distribution, and natural quality. Remote sensing techniques afford scientists a unique opportunity to characterize landscapes in order to assess groundwater resources, particularly in tectonically influenced areas. Aquifers in volcanic basins are considered the most productive aquifers in Latin America. Although topography is considered the primary driving force for groundwater flows in mountainous terrains, tectonic activity increases the complexity of these groundwater systems by altering the integrity of sedimentary rock units and the overlying drainage networks. Structural controls affect the primary hydraulic properties of the rock formations by developing barriers to flow in some cases and zones of preferential infiltration and subterranean in others. The study area focuses on the Quito Aquifer System (QAS) in Ecuador. The characterization of the hydrogeology started with a lineament analysis based on a combined remote sensing and digital terrain analysis approach. The application of classical tools for regional hydrogeological evaluation and shallow geophysical methods were useful to evaluate the impact of faulting and fracturing on the aquifer system. Given the spatial extension of the area and the complexity of the system, two levels of analysis were applied in this study. At the regional level, a lineament map was created for the QAS. Relationships between fractures, faults and lineaments and the configuration of the groundwater flow on the QAS were determined. At the local level, on the Plateaus region of the QAS, a detailed lineament map was obtained by using high-spatial-resolution satellite imagery and aspect map derived from a digital elevation model (DEM). This map was complemented by the analysis of morphotectonic indicators and shallow geophysics that characterize fracture patterns. The development of the groundwater flow system was studied, drawing upon data pertaining to the aquifer system physical characteristics and topography. Hydrochemistry was used to ascertain the groundwater evolution and verify the correspondence of the flow patterns proposed in the flow system analysis. Isotopic analysis was employed to verify the origin of groundwater. The results of this study show that tectonism plays a very important role for the hydrology of the QAS. The results also demonstrate that faults influence a great deal of the topographic characteristics of the QAS and subsequently the configuration of the groundwater flow. Moreover, for the Plateaus region, the results demonstrate that the aquifer flow systems are affected by secondary porosity. This is a new conceptualization of the functioning of the aquifers on the QAS that will significantly contribute to the development of better strategies for the management of this important water resource.

Evaluating the Effects of Sea Level Rise on Sea Turtle Nesting Sites: A Case Study of the Archie Carr National Wildlife Refuge

The purpose of this thesis was to determine the extent of sea level rise (SLR) impact on sea turtle nesting beach habitat on Archie Carr National Wildlife Refuge (NWR) as well as impacts on management strategies. The Archie Carr NWR is of exceptional importance due to the high density of Loggerhead, Leatherback, and Green sea turtles that nest there in the summer months. GIS data provided by the Archie Carr NWR and various SLR scenarios, provided by both the Intergovernmental Panel on Climate Change (IPCC) as well as leading scholars, were used to determine inundation area loss across the Refuge as well as nearby parcels targeted for possible acquisition. Inundation losses for the six scenarios were calculated to be in the 20-25% range. Approximately 26% of current lower priority parcels are reclassified as high priority when integrating this information. Therefore, a significant revision to future acquisition strategies is recommended.