Medical students' knowledge about end-of-life decision-making

The influence of medical students' knowledge concerning end-of-life care, considering ethical theories and clinical practice, remains controversial. We aimed to investigate medical students' knowledge of bioethical concepts related to moral kinds of death (euthanasia, disthanasia, and orthothanasia) and to analyze the influence of their clinical experience on practicing such approaches in a tertiary hospital in the state of São Paulo, Brazil. We interviewed 180 medical students [distributed in Group 1 (G1) - first to third- year students, and Group 2 (G2) - fourth to sixth-year students] to evaluate the influence of the course on "medical ethics" on ethical theories and clinical practice, using a closed questionnaire. The course on "medical ethics" did not distinguish the groups (P=0.704) in relation to bioethical concepts. Neologisms such as "cacothanasia" and "idiothanasia" were incorrectly viewed as bioethical concepts by 28% of the interviewees. Moreover, 45.3% of the sample considered health care professionals incapable of managing terminally ill patients, especially G2 (29%) as compared to G1 (16.5%, P=0.031). The concept of euthanasia was accepted by 41% of sample, as compared to 98.2% for orthothanasia. Among medical students that accepted ways to abbreviate life (22.9%), 30.1% belonged to G1, and only 16.1% to G2 (P=0.049). These medical students were unfamiliar with common bioethical concepts. Moreover, they considered healthcare professionals incapable of managing terminally ill patients. The ethical ideal of the "good death" reflects better acceptance of orthothanasia by medical students, suggesting a tendency to apply it in their future clinical practice.

Transcriptional Profiling of Organ‐Specific Autoimmunity in Human

Our understanding of the pathogenesis of organ‐specific autoinflammation has been restricted by limited access to the target organs. Peripheral blood, however, as a preferred transportation route for immune cells, provides a window to assess the entire immune system throughout the body. Transcriptional profiling with RNA stabilizing blood collection tubes reflects in vivo expression profiles at the time the blood is drawn, allowing detection of the disease activity in different samples or within the same sample over time. The main objective of this Ph.D. study was to apply gene‐expression microarrays in the characterization of peripheral blood transcriptional profiles in patients with autoimmune diseases. To achieve this goal a custom cDNA microarray targeted for gene‐expression profiling of human immune system was designed and produced. Sample collection and preparation was then optimized to allow gene‐expression profiling from whole‐blood samples. To overcome challenges resulting from minute amounts of sample material, RNA amplification was successfully applied to study pregnancy related immunosuppression in patients with multiple sclerosis (MS). Furthermore, similar sample preparation was applied to characterize longitudinal genome‐wide expression profiles in children with type 1 diabetes (T1D) associated autoantibodies and eventually clinical T1D. Blood transcriptome analyses, using both the ImmunoChip cDNA microarray with targeted probe selection and genome‐wide Affymetrix U133 Plus 2.0 oligonucleotide array, enabled monitoring of autoimmune activity. Novel disease related genes and general autoimmune signatures were identified. Notably, down‐regulation of the HLA class Ib molecules in peripheral blood was associated with disease activity in both MS and T1D. Taken together, these studies demonstrate the potential of peripheral blood transcriptional profiling in biomedical research and diagnostics. Imbalances in peripheral blood transcriptional activity may reveal dynamic changes that are relevant for the disease but might be completely missed in conventional cross‐sectional studies.

Landscape structure in the northern coast of Paraná state, a hotspot for the brazilian Atlantic Forest conservation

The "Serra do Mar" region comprises the largest remnant of the Brazilian Atlantic Forest. The coast of the Paraná State is part of the core area of the "Serra do Mar" corridor and where actions for biodiversity conservation must be planned. In this study we aimed at characterizing the landscape structure in the APA-Guaraqueçaba, the largest protected area in this region, in order to assist environmental policies of this region. Based on a supervised classification of a mosaic of LANDSAT-5-TM satellite images (from March 2009), we developed a map (1:75,000 scale) with seven classes of land use and land cover and analyzed the relative quantities of forests and modified areas in slopes and lowlands. The APA-Guaraqueçaba is comprised mainly by the Dense Ombrophilous Forest (68.6% of total area) and secondary forests (9.1%), indicating a forested landscape matrix; anthropogenic and bare soil areas (0.8%) and the Pasture/Grasslands class (4.2%) were less representative. Slopes were less fragmented and more preserved (96.3% of Dense Ombrophilous Forest and secondary forest) than lowlands (71.3%), suggesting that restoration initiatives in the lowlands must be stimulated in this region. We concluded that most of the region sustains well-conserved ecosystems, highlighting the importance of Paraná northern coast for the biodiversity maintenance of the Atlantic Forest.

ASSESSMENT OF A 5-YEAR-OLD REHABILITATED RIPARIAN FOREST: IS IT ALREADY SUSTAINABLE?

ABSTRACTAs important as the establishment of projects of ecological restoration is its assessment post-implementation to know whether the area is becoming self-sustainable or need to be redirected. In this way, this study aimed to know the current situation of a 5-year-old rehabilitated riparian forest,inserted in an anthropogenic impacted region,at the das Velhas River, Minas Gerais State, studying the canopy openness and recruitment of seedlings as plant indicators. 15 plots were allocated in the forest, where hemispherical photographs were taken to analyze the canopy openness and evaluate all seedlings from 0.30 m to 1.30 m height.Canopy openness ranged from 23.7% to 38.8% between seasons and only 192 seedlings were found,from 13 species, five of them exotic and aggressive. Although canopy openness was low, it seems that lateral penetration of light has been favoring the development and dominancy of plants from invasive species, whereas few native ones have been recruited. The exotic/invasive plants may compromise the success of restoration mainly by competition with native planted species. The outcomes evidenced an unsustainability of the riparian forest and the requirement of some management actions to control exotic and invasive plants and ensure the preservation of the area and its ecological roles over time.

First dice your dill – new methods and techniques in sample handling

This book is dedicated to celebrate the 60th birthday of Professor Rainer Huopalahti. Professor Rainer “Repe” Huopalahti has had, and in fact is still enjoying a distinguished career in the analysis of food and food related flavor compounds. One will find it hard to make any progress in this particular field without a valid and innovative sample handling technique and this is a field in which Professor Huopalahti has made great contributions. The title and the front cover of this book honors Professor Huopahti’s early steps in science. His PhD thesis which was published on 1985 is entitled “Composition and content of aroma compounds in the dill herb, Anethum graveolens L., affected by different factors”. At that time, the thesis introduced new technology being applied to sample handling and analysis of flavoring compounds of dill. Sample handling is an essential task that in just about every analysis. If one is working with minor compounds in a sample or trying to detect trace levels of the analytes, one of the aims of sample handling may be to increase the sensitivity of the analytical method. On the other hand, if one is working with a challenging matrix such as the kind found in biological samples, one of the aims is to increase the selectivity. However, quite often the aim is to increase both the selectivity and the sensitivity. This book provides good and representative examples about the necessity of valid sample handling and the role of the sample handling in the analytical method. The contributors of the book are leading Finnish scientists on the field of organic instrumental analytical chemistry. Some of them are also Repe’ s personal friends and former students from the University of Turku, Department of Biochemistry and Food Chemistry. Importantly, the authors all know Repe in one way or another and are well aware of his achievements on the field of analytical chemistry. The editorial team had a great time during the planning phase and during the “hard work editorial phase” of the book. For example, we came up with many ideas on how to publish the book. After many long discussions, we decided to have a limited edition as an “old school hard cover book” – and to acknowledge more modern ways of disseminating knowledge by publishing an internet version of the book on the webpages of the University of Turku. Downloading the book from the webpage for personal use is free of charge. We believe and hope that the book will be read with great interest by scientists working in the fascinating field of organic instrumental analytical chemistry. We decided to publish our book in English for two main reasons. First, we believe that in the near future, more and more teaching in Finnish Universities will be delivered in English. To facilitate this process and encourage students to develop good language skills, it was decided to be published the book in English. Secondly, we believe that the book will also interest scientists outside Finland – particularly in the other member states of the European Union. The editorial team thanks all the authors for their willingness to contribute to this book – and to adhere to the very strict schedule. We also want to thank the various individuals and enterprises who financially supported the book project. Without that support, it would not have been possible to publish the hardcover book.

Cadastral maps of irrigated areas by center pivots in the State of Minas Gerais, using CBERS-2B/CCD satellite imaging

Medium-resolution satellite images have been widely used for the identification and quantification of irrigated areas by center pivot. These areas, which present predominantly circular forms, can be easily identified by visual analyses of these images. In addition to identifying and quantifying areas irrigated by center pivot, other information that is associated to these areas is fundamental for producing cadastral maps. The goal of this work was to generate cadastral mapping of areas irrigated by center pivots in the State of Minas Gerais, Brazil, with the purpose of supplying information on irrigated agriculture. Using the satellite CBERS2B/CCD, images were used to identify and quantify irrigated areas and then associate these areas with a database containing information about: irrigated area, perimeter, municipality, path row, basin in which the pivot is located, and the date of image acquisition.3,781 center pivots systems were identified. The smallest area irrigated was 4.6 hectares and the largest one was 192.6 hectares. The total estimated value of irrigated area was 254,875 hectares. The largest number of center pivots appeared in the municipalities of Unaí and Paracatu, with 495 and 459 systems, respectively. Cadastral mapping is a very useful tool to assist and enhance information on irrigated agriculture in the State of Minas Gerais.

Detection of soybean planted areas through orbital images based on culture spectral dynamics

The soybean is important to the economy of Brazil, so the estimation of the planted area and the production with higher antecedence and reliability becomes essential. Techniques related to Remote Sensing may help to obtain this information at lower cost and less subjectivity in relation to traditional surveys. The aim of this study is to estimate the planted area with soybean culture in the crop of 2008/2009 in cities in the west of the state of Paraná, in Brazil, based on the spectral dynamics of the culture and through the use of the specific system of analysis for images of Landsat 5/TM satellite. The obtained results were satisfactory, because the classification supervised by Maximum Verisimilitude - MaxVer along with the techniques of the specific system of analysis for satellite images has allowed an estimate of soybean planted area (soybean mask), obtaining values ​​of the metrics of Global Accuracy with an average of 79.05% and Kappa Index over 63.50% in all cities. The monitoring of a reference area was of great importance for determining the vegetative phase in which the culture is more different from the other targets, facilitating the choice of training samples (ROIs) and avoiding misclassifications.

Analysis of land use and occupancy in permanent preservation areas according to the hydrography of Ribeirão Água Fria - Bofete, SP - Brazil

The use conflicts are determined by the inadequate occupations of the soil, as it is the case of soil occupation inside of permanent preservation areas. This study aimed to determine the classes of the soil use and if there are conflicts inside of permanent preservation areas along the drainage network of the Água Fria Stream watershed, located in Bofete city - São Paulo, Brazil. It locates geographically between the coordinates: 48°09'30" to 48°18'30" longitude WGr., 22°58'30" to 23°04'30" latitude S, with an area of 15242.84 ha. The map of soil use was elaborated through the interpretation directly in the computer screen of satellite digital image. In the orbital data, the study area is inserted in the quadrant A, of image TM/Landsat - 5, orbit 220, point 76, passage 9/8th/2007. The Geographical Information System used was CartaLinx. The conflict areas of the watershed were obtained from the crossing between the maps of soil use and of PPAs. The results allowed the conclusion that more than half of the area (51.09%) is occupied by pastures, reflex of sandy soils and low fertility. It was also verified that although almost half of the watershed is covered with some type of vegetation (48.78% of natural forest /reforestation), it has approximately a third of permanent preservation areas used inappropriately by pastures (88.15%), reforestation (10.42%) and exposed soil (1.43%), totaling 343.07ha of conflicting areas, in a total of 993.26 ha of PPAs.

Estimation of evaporation in the Banabuiú dam, in the state of Ceará, Brazil, by different combined methods, derived from the Penman equation

The state of Ceará, Brazil, has 75% of its area covered by Brazilian semiarid, with its peculiar features. In this state, the dams are constituted in water structure of strategic importance, ensuring, both in time and space, the development and supply of water to population. However, construction of reservoirs results in various impacts that should be carefully observed when deciding on their implementation. One of the impacts identified as negative is the increased evaporation, which constitutes a major component of water balance in reservoirs, especially in arid regions. Several methods for estimating evaporation have been proposed over time, many of them deriving from the Penman equation. This study evaluated six different methods for estimating evaporation in order to determine the most suitable for use in hydrological models for water balance in reservoirs in the state of Ceará. The tested methods were proposed by Penman, Kohler-Nordenson-Fox, Priestley-Taylor, deBruim-Keijman, Brutsaert-Stricker and deBruim. The methods presented good performance when tested for water balance during the dry season, and the Priestley-Taylor was the most appropriate, since the data from de simulated water balance with evaporation estimated by this method were the closest of the water balance data observed from measures of reservoir level and the elevation-volume curve provided by the Company of Management of Water Resources of the state of Ceará - COGERH.

Environmental adaptation of the source of the subbasin of Rico Stream, Monte Alto - SP, Brazil

The aim of this study was to define the photographic patterns that represent the use and occupation of the landcover of the "spring" of the Rico Stream subbasin, located at Monte Alto, state of São Paulo (SP), Brazil, for environmental adaptation regarding the Brazilian Forest Law. The mapping was performed using remote sensing techniques and visual interpretation of the World View image, followed by the digitalization of the net of drainage and vegetation (natural and agricultural) at the AutoCad software with documents and field work. The study area has 2141.53 ha and the results demonstrated that the main crop is sugarcane with 546.34 ha, followed by 251.22 ha of pastures, 191.71 ha of perennial crops, 57.31 ha of Eucalyptus and 49.52 ha of onion, confirming the advance of sugarcane culture in the region. The region has 375.04 ha of areas of permanent preservation (APPs), and of this area it was found that only 72.17 ha (19.24%) has arboreal vegetation or natural forest, and 302.87 ha of these areas need to be enriched and reforested with native vegetation from the region, according to the current legislation. The data of the area enable future proposals of models for environmental adaptation to the microbasin according to the current environmental legislation.

Management zones definition using soil chemical and physical attributes in a soybean area

Several equipments and methodologies have been developed to make available precision agriculture, especially considering the high cost of its implantation and sampling. An interesting possibility is to define management zones aim at dividing producing areas in smaller management zones that could be treated differently, serving as a source of recommendation and analysis. Thus, this trial used physical and chemical properties of soil and yield aiming at the generation of management zones in order to identify whether they can be used as recommendation and analysis. Management zones were generated by the Fuzzy C-Means algorithm and their evaluation was performed by calculating the reduction of variance and performing means tests. The division of the area into two management zones was considered appropriate for the present distinct averages of most soil properties and yield. The used methodology allowed the generation of management zones that can serve as source of recommendation and soil analysis; despite the relative efficiency has shown a reduced variance for all attributes in divisions in the three sub-regions, the ANOVA did not show significative differences among the management zones.

Spatial variability of mechanical resistance to penetration evaluated with mobile unit on haplic vertisol cultivated with mango

Since the advent of mechanized farming and intensive use of agricultural machinery and implements on the properties, the soil began to receive greater load of machinery traffic, which can cause increased soil compaction. The aim of this study was to evaluate the spatial variability of soil mechanical resistance to penetration (RP) in the layers of 0.00-0.10, 0.10-0.20, 0.20-0.30 and 0.30-0.40m, using geostatistics in an area cultivated with mango in Haplic Vertisol of the northeastern semi-arid, with mobile unit equipped with electronic penetrometer. The RP data was collected in 56 points from an area of 3 ha, and random soil samples were collected to determine the soil moisture and texture. For RP data analysis we used descriptive statistics and geostatistics. The soil mechanical resistance to penetration presented increased variability, with adjustment of the spherical and exponential semivariograms in the layers. We found that 42% of the area in the layer of 0.10-0.20m showed RP values above 2.70 MPa. Maximum values of RP were found in the layer of 0.19-0.27m, predominantly in 56% of the area.

Evaluation of sediment production and siltation in a small earth dam in Fernandópolis, SP

The siltation is a natural process, but can be accelerated by human actions and results in major problems for the reservoirs, reducing its useful volume for irrigation. An example of this problem was the reduction of the area of mirror water of Fernandópolis municipal dam in 48.3% during 20 years. Therefore, this study aimed to evaluate the production of sediments and siltation of Fernandópolis municipal dam from a methodology that can be applied to small earth dams for agricultural purposes. For this, it was monitored, monthly throughout the year, the volume of sediment deposited in the reservoir. The percentage of retention sediment in Fernandópolis municipal dam ranged from 53.9 to 94.5%, that associated with a high specific sediment yield, will cause its full silting in at most 57 years. It is recommended to minimize this process the restoration of permanent preservation areas and the removal of 17,500 m³ of sediment from the riverbed of the dam.

Use of surgical mesh of different compositions in the correction of the abdominal wall defect in rats

Objective: To analyze the performance of two surgical meshes of different compositions during the defect healing process of the abdominal wall of rats. Methods: thirty-three adult Wistar rats were anesthetized and subjected to removal of an area of 1.5 cm x 2 cm of the anterior abdominal wall, except for the skin; 17 animals had the defect corrected by edge-to-edge surgical suture of a mesh made of polypropylene + poliglecaprone (Group U - UltraproTM); 16 animals had the defect corrected with a surgical mesh made of polypropylene + polidioxanone + cellulose (Group P - ProceedTM). Each group was divided into two subgroups, according to the euthanasia moment (seven days or 28 days after the operation). Parameters analyzed were macroscopic (adherence), microscopic (quantification of mature and immature collagen) and tensiometric (maximum tension and maximum rupture strength). Results : there was an increase in collagen type I in the ProceedTM group from seven to 28 days, p = 0.047. Also, there was an increase in the rupture tension on both groups when comparing the two periods. There was a lower rupture tension and tissue deformity with ProceedTM mesh in seven days, becoming equal at day 28. Conclusion : the meshes retain similarities in the final result and more studies with larger numbers of animals must be carried for better assessment.

Effect of Hevea brasiliensis latex sap gel on healing of acute skin wounds induced on the back of rats

Objective : to evaluate the effect of topical delivery of latex cream-gel in acute cutaneous wounds induced on the back of rats. Methods : we subjected sixteen rats to dermo-epidermal excision of a round dorsal skin flap, with 2.5cm diameter. We divided the animals into two groups: Latex Group: application of cream-gel-based latex throughout the wound bed on postoperative days zero, three, six and nine; Control group: no treatment on the wound. Photographs of the lesions were taken on the procedure day and on the 6th and 14th postoperative days, for analyzing the area and the larger diameter of the wound. We carried out euthanasia of all animals on the 14th postoperative day, when we resected he dorsal skin and the underlying muscle layer supporting the wound for histopathological study. Results : there was no statistically significant difference in the percentage of wound closure, in the histopathological findings or in the reduction of the area and of the largest diameter of the wounds among the groups studied on the 14th postoperative day. Conclusion : according to the experimental conditions in which the study was conducted, latex cream-gel did not interfere in the healing of acute cutaneous wounds in rats.