Search results for: Pedro Henrique Alves Martins

Authors: Pedro Mario Gonzalez Jimenez

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The novelties introduced by the last Notice on agreements of minor importance tighten the application of the ‘De minimis’ safe harbour in the European Union. However, the undetermined legal concept of effect on trade between the Member States becomes importance at the same time. Therefore, the current analysis that the jurist should carry out in the European Union to determine if an agreement appreciably restrict competition under Article 101 of the Treaty on the Functioning of the European Union is double. Hence, it is necessary to know how to balance the significance in competition and the significance in effect on trade between the Member States. It is a crucial issue due to the negative delimitation of restriction of competition affects the positive one. The methodology of this research is rather simple. Beginning with a historical approach to the ‘De Minimis Rule’, their main problems and uncertainties will be found. So, after the analysis of normative documents and the jurisprudence of the Court of Justice of the European Union some proposals of ‘Lege ferenda’ will be offered. These proposals try to overcome the contradictions and questions that currently exist in the European Union as a consequence of the current legal regime of agreements of minor importance. The main findings of this research are the followings: Firstly, the effect on trade is another way to analyze the importance of an agreement different from the ‘De minimis rule’. In point of fact, this concept is singularly adapted to go through agreements that have as object the prevention, restriction or distortion of competition, as it is observed in the most famous European Union case-law. Thanks to the effect on trade, as long as the proper requirements are met there is no a restriction of competition under article 101 of the Treaty on the Functioning of the European Union, even if the agreement had an anti-competitive object. These requirements are an aggregate market share lower than 5% on any of the relevant markets affected by the agreement and turnover lower than 40 million of Euros. Secondly, as the Notice itself says ‘it is also intended to give guidance to the courts and competition authorities of the Member States in their application of Article 101 of the Treaty, but it has no binding force for them’. This reality makes possible the existence of different statements among the different Member States and a confusing perception of what a restriction of competition is. Ultimately, damage on trade between the Member States could be observed for this reason. The main conclusion is that the significant effect on trade between Member States is irrelevant in agreements that restrict competition because of their effects but crucial in agreements that restrict competition because of their object. Thus, the Member States should propose the incorporation of a similar concept in their legal orders in order to apply the content of the Notice. Otherwise, the significance of the restrictive agreement on competition would not be properly assessed.

Keywords: De minimis rule, effect on trade, minor importance agreements, safe harbour

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Authors: Marcelo Sanhueza Cartes, Nelson Maureira Carsalade

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This research evaluates the effectiveness of a pallet isolation device for the protection of selective-type industrial storage racks. The device works only in the longitudinal direction of the aisle, and it is made up of a platform installed on the rack beams. At both ends, the platform is connected to the rack structure by means of a spring-damper system working in parallel. A system of wheels is arranged between the isolation platform and the rack beams in order to reduce friction, decoupling of the movement and improve the effectiveness of the device. The latter is evaluated by the reduction of the maximum dynamic responses of basal shear load and story drift in relation to those corresponding to the same rack with the traditional construction system. In the first stage, numerical simulations of industrial storage racks were carried out with and without the pallet isolation device. The numerical results allowed us to identify the archetypes in which it would be more appropriate to carry out experimental tests, thus limiting the number of trials. In the second stage, experimental tests were carried out on a shaking table to a select group of full-scale racks with and without the proposed device. The movement simulated by the shaking table was based on the Mw 8.8 magnitude earthquake of February 27, 2010, in Chile, registered at the San Pedro de la Paz station. The peak ground acceleration (PGA) was scaled in the frequency domain to fit its response spectrum with the design spectrum of NCh433. The experimental setup contemplates the installation of sensors to measure relative displacement and absolute acceleration. The movement of the shaking table with respect to the ground, the inter-story drift of the rack and the pallets with respect to the rack structure were recorded. Accelerometers redundantly measured all of the above in order to corroborate measurements and adequately capture low and high-frequency vibrations, whereas displacement and acceleration sensors are respectively more reliable. The numerical and experimental results allowed us to identify that the pallet isolation period is the variable with the greatest influence on the dynamic responses considered. It was also possible to identify that the proposed device significantly reduces both the basal cut and the maximum inter-story drift by up to one order of magnitude.

Keywords: pallet isolation system, industrial storage racks, basal shear load, interstory drift.

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Authors: Maria C. Proença, Maria T. Rebelo, Marília Antunes, Maria J. Alves, Hugo Osório, Sofia Cunha, REVIVE team

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The environment of the mosquitoes complex Culex pipiens sl. in Portugal mainland is evaluated based in its abundance, using a data set georeferenced, collected during seven years (2006-2012) from May to October. The suitability of the different regions can be delineated using the relative abundance areas; the suitablility index is directly proportional to disease transmission risk and allows focusing mitigation measures in order to avoid outbreaks of vector-borne diseases. The interest in the Culex pipiens complex is justified by its medical importance: the females bite all warm-blooded vertebrates and are involved in the circulation of several arbovirus of concern to human health, like West Nile virus, iridoviruses, rheoviruses and parvoviruses. The abundance of Culex pipiens mosquitoes were documented systematically all over the territory by the local health services, in a long duration program running since 2006. The environmental factors used to characterize the vector habitat are land use/land cover, distance to cartographed water bodies, altitude and latitude. Focus will be on the mosquito females, which gonotrophic cycle mate-bloodmeal-oviposition is responsible for the virus transmission; its abundance is the key for the planning of non-aggressive prophylactic countermeasures that may eradicate the transmission risk and simultaneously avoid chemical ambient degradation. Meteorological parameters such as: air relative humidity, air temperature (minima, maxima and mean daily temperatures) and daily total rainfall were gathered from the weather stations network for the same dates and crossed with the standardized females’ abundance in a geographic information system (GIS). Mean capture and percentage of above average captures related to each variable are used as criteria to compute a threshold for each meteorological parameter; the difference of the mean capture above/below the threshold was statistically assessed. The meteorological parameters measured at the net of weather stations all over the country are averaged by month and interpolated to produce raster maps that can be segmented according to the meaningful thresholds for each parameter. The intersection of the maps of all the parameters obtained for each month show the evolution of the suitable meteorological conditions through the mosquito season, considered as May to October, although the first and last month are less relevant. In parallel, mean and above average captures were related to the physiographic parameters – the land use/land cover classes most relevant in each month, the altitudes preferred and the most frequent distance to water bodies, a factor closely related with the mosquito biology. The maps produced with these results were crossed with the meteorological maps previously segmented, in order to get an index of suitability for the complex Culex pipiens evaluated all over the country, and its evolution from the beginning to the end of the mosquitoes season.

Keywords: suitability index, Culex pipiens, habitat evolution, GIS model

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Authors: Michelle S. Pereira, Analice C. Azevedo, Julliane D. Medeiros, Ana Claudia S. Martins, Didier S. Castellano-Filho, Claudio G. Diniz, Vania L. Silva

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Vaginal microbiota is a complex ecosystem, composed by aerobic and anaerobic bacteria, living in a dynamic equilibrium. Lactobacillus spp. are predominant in vaginal ecosystem, and factors such as immunity and hormonal variations may lead to disruptions, resulting in proliferation of opportunistic pathogens. Bacterial vaginosis (BV) is a polymicrobial syndrome, caused by an increasing of anaerobic bacteria replacing Lactobacillus spp. Microorganisms such as Gardnerella vaginalis, Mycoplasma hominis, Mobiluncus spp., and Atopobium vaginae can be found in BV, which may also be associated to other infections such as by Human Papillomavirus (HPV). HPV is highly prevalent in sexually active women, and is considered a risk factor for development of cervical cancer. As long as few data is available on vaginal microbiota of women with HPV-associated cervical lesions, our objectives were to evaluate the diversity in vaginal ecosystem in these women. To all patients, clinical and socio-demographic data were collected after gynecological examination. This study was approved by the Ethics Committee from Federal University of Juiz de Fora, Minas Gerais, Brazil. Vaginal secretion and cervical scraping were collected. Gram-stained smears were evaluated to establish Nugent score for BV determination. Viral and bacterial DNA obtained was used as template for HPV genotyping (PCR) and bacterial fingerprint (REP-PCR). In total 31 patients were included (mean age 35 and 93.6% sexually active). The Nugent score showed that 38.7% were BV. From the medical records, Pap smear tests showed that 32.3% had low grade squamous epithelial lesion (LSIL), 29% had high grade squamous epithelial lesion (HSIL), 25.8% had atypical squamous cells of undetermined significance (ASC-US) and 12.9% with atypical squamous cells that would not exclude high-grade lesion (ASC-H). All participants were HPV+. HPV-16 was the most frequent (87.1%), followed by HPV-18 (61.3%). HPV-31, HPV-52 and HPV-58 were also detected. Coinfection HPV-16/HPV-18 was observed in 75%. In the 18-30 age group, HPV-16 was detected in 40%, and HPV-16/HPV-18 coinfection in 35%. HPV-16 was associated to 30% of ASC-H and 20% of HSIL patients. BV was observed in 50% of HPV-16+ participants and in 45% of HPV-16/HPV-18+. Fingerprints of bacterial communities showed clusters with low similarity suggesting high heterogeneity in vaginal microbiota within the sampled group. Overall, the data is worrisome once cervical-cancer highly risk-associated HPV-types were identified. The high microbial diversity observed may be related to the different levels of cellular lesions, and different physiological conditions of the participants (age, social behavior, education). Further prospective studies are needed to better address correlations and BV and microbial imbalance in vaginal ecosystems which would be related to the different cellular lesions in women with HPV infections. Supported by FAPEMIG, CNPq, CAPES, PPGCBIO/UFJF.

Keywords: human papillomavirus, bacterial vaginosis, bacterial diversity, cervical cancer

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Authors: Catarina Belchior, Catarina Martins, Sara Mendes, Ana Rita S. Valente, Elsa Marta Soares

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Introduction: The negative feelings and attitudes that a person who stutters can develop are extremely relevant when considering assessment and intervention in Speech and Language Therapy. This relates to the fact that the person who stutters can experience feelings such as shame, fear and negative beliefs when communicating. Considering the complexity and importance of integrating diverse aspects in stuttering intervention, it is central to identify those emotions as early as possible. Therefore, this research aimed to achieve the translation, adaptation to European Portuguese and to analyze the content validation of the Preschooler Awareness Stuttering Survey (Abbiati, Guitar & Hutchins, 2015), an instrument that allows the assessment of the impact of stuttering on preschool children who stutter considering feelings and attitudes. Methodology: Cross-sectional descriptive qualitative research. The following methodological procedures were followed: translation, back-translation, panel of experts and pilot study. This abstract describes the results of the first three phases of this process. The translation was accomplished by two Speech Language Therapists (SLT). Both professionals have more than five years of experience and are users of English language. One of them has a broad experience in the field of stuttering. Back-translation was conducted by two bilingual individuals without experience in health or any knowledge about the instrument. The panel of experts was composed by 3 different SLT, experts in the field of stuttering. Results and Discussion: In the translation and back-translation process it was possible to verify differences in semantic and idiomatic equivalences of several concepts and expressions, as well as the need to include new information to enhance the understanding of the application of the instrument. The meeting between the two translators and the researchers allowed the achievement of a consensus version that was used in back-translation. Considering adaptation and content validation, the main change made by the experts was the conceptual equivalence of the questions and answers of the instrument's sheets. Considering that in the translated consensus version the questions began with various nouns such as 'is' or 'the cow' and that the answers did not contain the adverb 'much' as in the original instrument, the panel agreed that it would be more appropriate if the questions all started with 'how' and that all the answers should present the adverb 'much'. This decision was made to ensure that the translate instrument would be similar to the original and so that the results obtained could be comparable between the original and the translated instrument. There was also elaborated one semantic equivalence between concepts. The panel of experts found that all other items and specificities of the instrument were adequate, concluding the adequacy of the instrument considering its objectives and its intended target population. Conclusion: This research aspires to diversify the existing validated resources in this scope, adding a new instrument that allows the assessment of preschool children who stutter. Consequently, it is hoped that this instrument will provide a real and reliable assessment that can lead to an appropriate therapeutic intervention according to the characteristics and needs of each child.

Keywords: stuttering, assessment, feelings and attitudes, speech language therapy

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Authors: Ana L. M. Pavan, Guilherme Giacomini, Allan F. F. Alves, Marcela De Oliveira, Fernando A. B. Neto, Maria E. D. Rosa, Andre P. Trindade, Diana R. De Pina

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Mammography is a worldwide image modality used to diagnose breast cancer, even in asymptomatic women. Due to its large availability, mammograms can be used to measure breast density and to predict cancer development. Women with increased mammographic density have a four- to sixfold increase in their risk of developing breast cancer. Therefore, studies have been made to accurately quantify mammographic breast density. In clinical routine, radiologists perform image evaluations through BIRADS (Breast Imaging Reporting and Data System) assessment. However, this method has inter and intraindividual variability. An automatic objective method to measure breast density could relieve radiologist’s workload by providing a first aid opinion. However, pectoral muscle is a high density tissue, with similar characteristics of fibroglandular tissues. It is consequently hard to automatically quantify mammographic breast density. Therefore, a pre-processing is needed to segment the pectoral muscle which may erroneously be quantified as fibroglandular tissue. The aim of this work was to develop an automatic algorithm to segment and extract pectoral muscle in digital mammograms. The database consisted of thirty medio-lateral oblique incidence digital mammography from São Paulo Medical School. This study was developed with ethical approval from the authors’ institutions and national review panels under protocol number 3720-2010. An algorithm was developed, in Matlab® platform, for the pre-processing of images. The algorithm uses image processing tools to automatically segment and extract the pectoral muscle of mammograms. Firstly, it was applied thresholding technique to remove non-biological information from image. Then, the Hough transform is applied, to find the limit of the pectoral muscle, followed by active contour method. Seed of active contour is applied in the limit of pectoral muscle found by Hough transform. An experienced radiologist also manually performed the pectoral muscle segmentation. Both methods, manual and automatic, were compared using the Jaccard index and Bland-Altman statistics. The comparison between manual and the developed automatic method presented a Jaccard similarity coefficient greater than 90% for all analyzed images, showing the efficiency and accuracy of segmentation of the proposed method. The Bland-Altman statistics compared both methods in relation to area (mm²) of segmented pectoral muscle. The statistic showed data within the 95% confidence interval, enhancing the accuracy of segmentation compared to the manual method. Thus, the method proved to be accurate and robust, segmenting rapidly and freely from intra and inter-observer variability. It is concluded that the proposed method may be used reliably to segment pectoral muscle in digital mammography in clinical routine. The segmentation of the pectoral muscle is very important for further quantifications of fibroglandular tissue volume present in the breast.

Keywords: active contour, fibroglandular tissue, hough transform, pectoral muscle

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Authors: Cinthia G. P. Calou, Franz J. Antezana, Ana I. O. Nicolau, Eveliny S. Martins, Paula R. A. L. Soares, Glauberto S. Quirino, Dayanne R. Oliveira, Priscila S. Aquino, Régia C. M. B. Castro, Ana K. B. Pinheiro

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Introduction: As an integral part of the health-disease process, gestation is a period in which the social insertion of women can influence, in a positive or negative way, the course of the pregnancy-puerperal cycle. Thus, evaluating the quality of life of this population can redirect the implementation of innovative practices in the quest to make them more effective and real for the promotion of a more humanized care. This study explores the associations between the obstetric factors with affected areas of health-related quality of life of pregnant women with habitual risk. Methods: This is a cross-sectional, quantitative study conducted in three public facilities and a private service that provides prenatal care in the city of Fortaleza, Ceara, Brazil. The sample consisted of 261 pregnant women who underwent low-risk prenatal care and were interviewed from September to November 2014. The collection instruments were a questionnaire containing socio-demographic and obstetric variables, in addition to the Brazilian version of the Mother scale Generated Index (MGI) characterized by being a specific and objective instrument, consisting of a single sheet and subdivided into three stages. It allows identifying the areas of life of the pregnant woman that are most affected, which could go unnoticed by the pre-formulated measurement instruments. The obstetric data, as well as the data concerning the application of the MGI scale, were compiled and analyzed through the statistical program Statistical Package for the Social Sciences (SPSS), version 20.0. After the compilation, a descriptive analysis was carried out. Then, associations were made between some variables. The tests applied were the Pearson Chi-Square and the Fisher's exact test. The odds ratio was also calculated. These associations were considered statistically significant when the p (probability) value was less than or equal to a level of 5% (α = 0.05) in the tests performed. Results: The variables that negatively reflected the quality of life of the pregnant women and presented a significant association with the polaciuria were: gestational age (p = 0.022) and parity (p = 0.048). Episodes of nausea and vomiting also showed significant with gestational age correlation (p = 0.0001). Evaluating the crossing of stress, we observed a significant association with parity (p = 0.0001). In turn, emotional lability revealed dependence on the variable type of delivery (p = 0.009). Conclusion: The health professionals involved in the assistance to the pregnant woman can understand how the process of gestation is experienced, considering all its peculiar transformations; to meet their individual needs, stimulating their autonomy and their power of choice, envisaging the achievement of a better quality of life related to health in the perspective of health promotion.

Keywords: health-related quality of life, obstetric nursing, pregnant women, prenatal care

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Authors: Teresa Sarmento de Beires, Sofia Padilha, Pedro Arantes, Joana Ribeiro, Andreia Eiras

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Background: Trichotillomania is a psychiatric condition that is very challenging to treat, with no first-line medications approved by any medical agency. It is defined as a recurrent compulsive habit of pulling out one's own hair, usually from the scalp and eyebrows area, but it can also affect eyelashes or any other hair-bearing area. N-acetylcysteine, a glutamate modulator, has been studied as a possible treatment for several psychiatric and neurological disorders, considering its role in attenuating pathophysiological processes responsible for compulsive behaviors and, therefore, trichotillomania. Objective: This study aims to determine the efficacy of N-acetylcysteine in the treatment of adults with trichotillomania. Methodology: The authors researched guidelines, standards of clinical guidance, systematic reviews, meta-analyses, and randomized clinical trials, published in the last 20 years using the MeSH terms: "Trichotillomania” and “N-acetylcysteine” in the following databases: PubMed, Cochrane library, National Guideline Clearing House, National Institute of Health and Care Excellence (NICE), Canadian Medical Association Practice Guidelines and Database of Abstracts of Reviews of Effectiveness (DARE). The Strength of Recommendation Taxonomy (SORT) Scale, from the American Family Physician, was used to evaluate the level of evidence and assign the strength of recommendation. Results: The research found fifteen articles, among which only three were eligible according to the inclusion criteria: 1. systematic review and 2. meta-analyses. There was evidence of a probable beneficial effect of N-acetylcysteine on treatment response and reduction of trichotillomania symptom severity in adults, with moderate certainty in the effect estimate. There was no evidence of effectiveness with the use of inositol, antioxidants, naltrexone, or selective serotonin reuptake inhibitors (SSRIs) in the treatment of adults with trichotillomania. Clomipramine and Olanzapine showed potential treatment benefits, with low certainty. N-acetylcysteine had the least severe side effect profile in adults compared with the other potentially beneficial pharmacological treatments. Conclusion: Evidence points towards the effectiveness of N-acetylcysteine in the treatment of adults with trichotillomania, which exhibits a good tolerability profile with minimal adverse effects. Therefore, the authors attribute a level of evidence 2, the strength of recommendation B, to the prescription of N-acetylcysteine in the treatment of adults suffering from trichotillomania (SORT analysis). Further investigation is needed in order to extract high-quality conclusions from the meta-analysis.

Keywords: trichotillomania, hair pulling, treatment, n-acetylcysteine

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Authors: Angela T. H. Kwan, Saman Arfaie, Joseph Therriault, Zahra Azizi, Firoza Z. Lussier, Cecile Tissot, Mira Chamoun, Gleb Bezgin, Stijn Servaes, Jenna Stevenon, Nesrine Rahmouni, Vanessa Pallen, Serge Gauthier, Pedro Rosa-Neto

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Alzheimer’s disease (AD) can be detected in living people using in vivo biomarkers of amyloid-β (Aβ) and tau, even in the absence of cognitive impairment during the preclinical phase. [¹⁸F]-MK-6420 is a high affinity positron emission tomography (PET) tracer that quantifies tau neurofibrillary tangles, but its ability to predict cognitive changes associated with early AD symptoms, such as memory decline, is unclear. Here, we assess the prognostic accuracy of baseline [18F]-MK-6420 tau PET for predicting longitudinal memory decline in asymptomatic elderly individuals. In a longitudinal observational study, we evaluated a cohort of cognitively normal elderly participants (n = 111) from the Translational Biomarkers in Aging and Dementia (TRIAD) study (data collected between October 2017 and July 2020, with a follow-up period of 12 months). All participants underwent tau PET with [¹⁸F]-MK-6420 and Aβ PET with [¹⁸F]-AZD-4694. The exclusion criteria included the presence of head trauma, stroke, or other neurological disorders. There were 111 eligible participants who were chosen based on the availability of Aβ PET, tau PET, magnetic resonance imaging (MRI), and APOEε4 genotyping. Among these participants, the mean (SD) age was 70.1 (8.6) years; 20 (18%) were tau PET positive, and 71 of 111 (63.9%) were women. A significant association between baseline Braak I-II [¹⁸F]-MK-6240 SUVR positivity and change in composite memory score was observed at the 12-month follow-up, after correcting for age, sex, and years of education (Logical Memory and RAVLT, standardized beta = -0.52 (-0.82-0.21), p < 0.001, for dichotomized tau PET and -1.22 (-1.84-(-0.61)), p < 0.0001, for continuous tau PET). Moderate cognitive decline was observed for A+T+ over the follow-up period, whereas no significant change was observed for A-T+, A+T-, and A-T-, though it should be noted that the A-T+ group was small.Our results indicate that baseline tau neurofibrillary tangle pathology is associated with longitudinal changes in memory function, supporting the use of [¹⁸F]-MK-6420 PET to predict the likelihood of asymptomatic elderly individuals experiencing future memory decline. Overall, [¹⁸F]-MK-6420 PET is a promising tool for predicting memory decline in older adults without cognitive impairment at baseline. This is of critical relevance as the field is shifting towards a biological model of AD defined by the aggregation of pathologic tau. Therefore, early detection of tau pathology using [¹⁸F]-MK-6420 PET provides us with the hope that living patients with AD may be diagnosed during the preclinical phase before it is too late.

Keywords: alzheimer’s disease, braak I-II, in vivo biomarkers, memory, PET, tau

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Authors: Mariana L. de Araújo, Pedro P. M. Menezes

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Research on strategic human resource management (SHRM) has made progress in the last few decades, showing a relationship between policies and practices of human resource management (HRM) and improving organizational results. That's because demonstrating the effectiveness of any HRM or other organizational practice, which means the extent that this can operate as a tool to achieve organizational performance, is a complex and arduous task to execute. Even today, there isn't consensus about "effectiveness," and the tools to measure the effectiveness are disconnected and not convincing. It is not different from the performance management system (PMS) effectiveness. A disproportionate focus on specific criteria adopted and an accumulation of studies that don't relate to the others, which damages the development of the field. Therefore, it aimed to evaluate the effectiveness of the PMS through models, dimensions, criteria, and measures. The objective of this study is to propose a theoretical-integrative model for evaluating PMS based on the literature in the PMS field. So, the PRISMA protocol was applied to carry out a systematic review, resulting in 57 studies. After performing the content analysis, we identified six dimensions: learning, societal impact, reaction, financial results, operational results and transfer, and 22 categories. In this way, a theoretical-integrative model for assessing the effectiveness of PMS was proposed based on the findings of this study, in which it was possible to confirm that the effectiveness construct is somewhat complex when viewing that most of the reviewed studies considered multiple dimensions in their assessment. In addition, we identified that the most immediate and proximal results of PMS are the most adopted by the studies; conversely, the studies adopted less distal outcomes to assess the effectiveness of PMS. Another finding of this research is that the reviewed studies predominantly analyze from the individual or psychological perspective, even when it comes to criteria whose phenomena are at an organizational level. Therefore, this study converges with a trend recently identified when referring to a process of "psychologization" in which GP studies, in general, have demonstrated macro results of the GP system from an individual perspective. Therefore, given the identification of a methodological pattern, the predominant influence of individual and psychological aspects in studies on HRM in administration is highlighted, demonstrated by the reflection on the practically absolute way of measuring the effectiveness of PMS from perceptual and subjective measures. Therefore, based on the recognition of the patterns identified, the model proposed to promote studies on the subject more broadly and profoundly to broaden and deepen the perspective of the field of management's interests so that the evaluation of the effectiveness of PMS can promote inputs on the impact of the PMS system in organizational performance. Finally, the findings encourage reflections on assessing the effectiveness of PMS through the theoretical-integrative model developed so that the field can promote new theoretical and practical perspectives.

Keywords: performance management, strategic human resource management, effectiveness, organizational performance

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Authors: Sonia Butalia, Huong Luu, Alexis Guigue, Karen J. B. Martins, Khanh Vu, Scott W. Klarenbach

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Obesity-related health conditions impose a substantial economic burden on payers due to increased healthcare use. Estimates of healthcare resource use and costs associated with obesity-related comorbidities are needed to inform policies and interventions targeting these conditions. Methods: Adults living with obesity were identified (a procedure-related body mass index code for class 2/3 obesity between 2012 and 2019 in Alberta, Canada; excluding those with bariatric surgery), and outcomes were compared over 1-year (2019/2020) between those who had and did not have specific obesity-related comorbidities. The probability of using a healthcare service (based on the odds ratio of a zero [OR-zero] cost) was compared; 95% confidence intervals (CI) were reported. Logistic regression and a generalized linear model with log link and gamma distribution were used for total healthcare cost comparisons ($CDN); cost ratios and estimated cost differences (95% CI) were reported. Potential socio-demographic and clinical confounders were adjusted for, and incremental cost differences were representative of a referent case. Results: A total of 220,190 adults living with obesity were included; 44% had hypertension, 25% had osteoarthritis, 24% had type-2 diabetes, 17% had cardiovascular disease, 12% had insulin resistance, 9% had chronic back pain, and 4% of females had polycystic ovarian syndrome (PCOS). The probability of hospitalization, ED visit, and ambulatory care was higher in those with a following obesity-related comorbidity versus those without: chronic back pain (hospitalization: 1.8-times [OR-zero: 0.57 [0.55/0.59]] / ED visit: 1.9-times [OR-zero: 0.54 [0.53/0.56]] / ambulatory care visit: 2.4-times [OR-zero: 0.41 [0.40/0.43]]), cardiovascular disease (2.7-times [OR-zero: 0.37 [0.36/0.38]] / 1.9-times [OR-zero: 0.52 [0.51/0.53]] / 2.8-times [OR-zero: 0.36 [0.35/0.36]]), osteoarthritis (2.0-times [OR-zero: 0.51 [0.50/0.53]] / 1.4-times [OR-zero: 0.74 [0.73/0.76]] / 2.5-times [OR-zero: 0.40 [0.40/0.41]]), type-2 diabetes (1.9-times [OR-zero: 0.54 [0.52/0.55]] / 1.4-times [OR-zero: 0.72 [0.70/0.73]] / 2.1-times [OR-zero: 0.47 [0.46/0.47]]), hypertension (1.8-times [OR-zero: 0.56 [0.54/0.57]] / 1.3-times [OR-zero: 0.79 [0.77/0.80]] / 2.2-times [OR-zero: 0.46 [0.45/0.47]]), PCOS (not significant / 1.2-times [OR-zero: 0.83 [0.79/0.88]] / not significant), and insulin resistance (1.1-times [OR-zero: 0.88 [0.84/0.91]] / 1.1-times [OR-zero: 0.92 [0.89/0.94]] / 1.8-times [OR-zero: 0.56 [0.54/0.57]]). After fully adjusting for potential confounders, the total healthcare cost ratio was higher in those with a following obesity-related comorbidity versus those without: chronic back pain (1.54-times [1.51/1.56]), cardiovascular disease (1.45-times [1.43/1.47]), osteoarthritis (1.36-times [1.35/1.38]), type-2 diabetes (1.30-times [1.28/1.31]), hypertension (1.27-times [1.26/1.28]), PCOS (1.08-times [1.05/1.11]), and insulin resistance (1.03-times [1.01/1.04]). Conclusions: Adults with obesity who have specific disease-related health conditions have a higher probability of healthcare use and incur greater costs than those without specific comorbidities; incremental costs are larger when other obesity-related health conditions are not adjusted for. In a specific referent case, hypertension was costliest (44% had this condition with an additional annual cost of $715 [$678/$753]). If these findings hold for the Canadian population, hypertension in persons with obesity represents an estimated additional annual healthcare cost of $2.5 billion among adults living with obesity (based on an adult obesity rate of 26%). Results of this study can inform decision making on investment in interventions that are effective in treating obesity and its complications.

Keywords: administrative data, healthcare cost, obesity-related comorbidities, real world evidence

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Authors: Valeria Velasco, Ana M. Bonilla, José L. Vergara, Alcides Lofa, Jorge Campos, Pedro Rojas-García

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Staphylococcus aureus is both commensal bacterium and opportunistic pathogen that can cause different diseases in humans and can rapidly develop antimicrobial resistance. Since this bacterium has the ability to colonize the nares and skin of humans and animals, there is a risk of contamination of food in different steps of the food chain supply. Emerging strains have been detected in food-producing animals and meat, such as methicillin-resistant S. aureus (MRSA). The aim of this study was to determine the prevalence and oxacillin susceptibility of S. aureus in the pork chain supply in Chile and to suggest some natural antimicrobials for control. A total of 487 samples were collected from pigs (n=332), carcasses (n=85), and retail pork meat (n=70). Presumptive S. aureus colonies were isolated by selective enrichment and culture media. The confirmation was carried out by biochemical testing (Api® Staph) and molecular technique PCR (detection of nuc and mecA genes, associated with S. aureus and methicillin resistance, respectively). The oxacillin (β-lactam antibiotic that replaced methicillin) susceptibility was assessed by minimum inhibitory concentration (MIC) using the Epsilometer test (Etest). A preliminary assay was carried out to test thymol, carvacrol, oregano essential oil (Origanum vulgare L.), Maqui or Chilean wineberry extract (Aristotelia chilensis (Mol.) Stuntz) as anti-staphylococcal agents using the disc diffusion method at different concentrations. The overall prevalence of S. aureus in the pork chain supply reached 33.9%. A higher prevalence of S. aureus was determined in carcasses (56.5%) than in pigs (28.3%) and pork meat (32.9%) (P ≤ 0.05). The prevalence of S. aureus in pigs sampled at farms (40.6%) was higher than in pigs sampled at slaughterhouses (23.3%) (P ≤ 0.05). The contamination of no packaged meat with S. aureus (43.1%) was higher than in packaged meat (5.3%) (P ≤ 0.05). The mecA gene was not detected in S. aureus strains isolated in this study. Two S. aureus strains exhibited oxacillin resistance (MIC ≥ 4µg/mL). Anti-staphylococcal activity was detected in solutions of thymol, carvacrol, and oregano essential oil at all concentrations tested. No anti-staphylococcal activity was detected in Maqui extract. Finally, S. aureus is present in the pork chain supply in Chile. Although the mecA gene was not detected, oxacillin resistance was found in S. aureus and could be attributed to another resistance mechanism. Thymol, carvacrol, and oregano essential oil could be used as anti-staphylococcal agents at low concentrations. Research project Fondecyt No. 11140379.

Keywords: antimicrobials, mecA gen, nuc gen, oxacillin susceptibility, pork meat

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Authors: Juan-Pedro Rica-Peromingo

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Nowadays, corpus linguistics has become a key research methodology for Translation Studies, which broadens the scope of cross-linguistic studies. In the case of the study presented here, the approach used focuses on learners with little or no experience to study, at an early stage, general mistakes and errors, the correct or incorrect use of translation strategies, and to improve the translational competence of the students. Led by Sylviane Granger and Marie-Aude Lefer of the Centre for English Corpus Linguistics of the University of Louvain, the MUST corpus (MUltilingual Student Translation Corpus) is an international project which brings together partners from Europe and worldwide universities and connects Learner Corpus Research (LCR) and Translation Studies (TS). It aims to build a corpus of translations carried out by students including both direct (L2 > L1) an indirect (L1 > L2) translations, from a great variety of text types, genres, and registers in a wide variety of languages: audiovisual translations (including dubbing, subtitling for hearing population and for deaf population), scientific, humanistic, literary, economic and legal translation texts. This paper focuses on the work carried out by the Spanish team from the Complutense University (UCMA), which is part of the MUST project, and it describes the specific features of the corpus built by its members. All the texts used by UCMA are either direct or indirect translations between English and Spanish. Students’ profiles comprise translation trainees, foreign language students with a major in English, engineers studying EFL and MA students, all of them with different English levels (from B1 to C1); for some of the students, this would be their first experience with translation. The MUST corpus is searchable via Hypal4MUST, a web-based interface developed by Adam Obrusnik from Masaryk University (Czech Republic), which includes a translation-oriented annotation system (TAS). A distinctive feature of the interface is that it allows source texts and target texts to be aligned, so we can be able to observe and compare in detail both language structures and study translation strategies used by students. The initial data obtained point out the kind of difficulties encountered by the students and reveal the most frequent strategies implemented by the learners according to their level of English, their translation experience and the text genres. We have also found common errors in the graduate and postgraduate university students’ translations: transfer errors, lexical errors, grammatical errors, text-specific translation errors, and cultural-related errors have been identified. Analyzing all these parameters will provide more material to bring better solutions to improve the quality of teaching and the translations produced by the students.

Keywords: corpus studies, students’ corpus, the MUST corpus, translation studies

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Authors: Pedro Batista, André Vinha, Filipe Castelo, Bárbara Costa, Ricardo Sousa, Raquel Ricardo, André Pinto

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Background: Septic arthritis is a diagnosis that must be considered in any patient presenting with acute joint swelling and fever. Among the several risk factors for septic arthritis, such as age, rheumatoid arthritis, recent surgery, or skin infection, diabetes mellitus can sometimes be the main risk factor. Staphylococcus aureus is the most common pathogen isolated in septic arthritis; however, it is uncommon in monomicrobial necrotizing fasciitis. Objectives: A case report of concomitant septic arthritis and necrotizing fasciitis in a patient with undiagnosed diabetes based on clinical history. Study Design & Methods: We report a case of a 58-year-old Portuguese previously healthy man who presented to the emergency department with fever and left knee swelling and pain for two days. The blood work revealed ketonemia of 6.7 mmol/L and glycemia of 496 mg/dL. The vital signs were significant for a temperature of 38.5 ºC and 123 bpm of heart rate. The left knee had edema and inflammatory signs. Computed tomography of the left knee showed diffuse edema of the subcutaneous cellular tissue and soft tissue air bubbles. A diagnosis of septic arthritis and necrotising fasciitis was made. He was taken to the operating room for surgical debridement. The samples collected intraoperatively were sent for microbiological analysis, revealing infection by multi-sensitive Staphylococcus aureus. Given this result, the empiric flucloxacillin (500 mg IV) and clindamycin (1000 mg IV) were maintained for 3 weeks. On the seventh day of hospitalization, there was a significant improvement in subcutaneous and musculoskeletal tissues. After two weeks of hospitalization, there was no purulent content and partial closure of the wounds was possible. After 3 weeks, he was switched to oral antibiotics (flucloxacillin 500 mg). A week later, a urinary infection by Pseudomonas aeruginosa was diagnosed and ciprofloxacin 500 mg was administered for 7 days without complications. After 30 days of hospital admission, the patient was discharged home and recovered. Results: The final diagnosis of concomitant septic arthritis and necrotizing fasciitis was made based on the imaging findings, surgical exploration and microbiological tests results. Conclusions: Early antibiotic administration and surgical debridement are key in the management of septic arthritis and necrotizing fasciitis. Furthermore, risk factors control (euglycemic blood glucose levels) must always be taken into account given the crucial role in the patient's recovery.

Keywords: septic arthritis, Necrotizing fasciitis, diabetes, Staphylococcus Aureus

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Authors: Michael Nolte, Iwona Kasior, Kala Flagg, Spiro Karavatas

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Background: Cryotherapy has been used as a post-exercise recovery modality for decades. Whole-body cryotherapy (WBC) is an intervention which involves brief exposures to extremely cold air in order to induce therapeutic effects. It is currently being investigated for its effectiveness in treating certain exercise-induced impairments. Purpose: The purpose of this systematic review was to determine whether WBC as a recovery intervention is more, less, or equally as effective as other interventions at reducing perceived levels of muscle soreness and promoting recovery of muscle function after exercise-induced muscle damage (EIMD) from running. Methods: A systematic review of the current literature was performed utilizing the following MeSH terms: cryotherapy, whole-body cryotherapy, exercise-induced muscle damage, muscle soreness, muscle recovery, and running. The databases utilized were PubMed, CINAHL, EBSCO Host, and Google Scholar. Articles were included if they were published within the last ten years, had a CEBM level of evidence of IIb or higher, had a PEDro scale score of 5 or higher, studied runners as primary subjects, and utilized both perceived levels of muscle soreness and recovery of muscle function as dependent variables. Articles were excluded if subjects did not include runners, if the interventions included PBC instead of WBC, and if both muscle performance and perceived muscle soreness were not assessed within the study. Results: Two of the four articles revealed that WBC was significantly more effective than treatment interventions such as far-infrared radiation and passive recovery at reducing perceived levels of muscle soreness and restoring muscle power and endurance following simulated trail runs and high-intensity interval running, respectively. One of the four articles revealed no significant difference between WBC and passive recovery in terms of reducing perceived muscle soreness and restoring muscle power following sprint intervals. One of the four articles revealed that WBC had a harmful effect compared to CWI and passive recovery on both perceived muscle soreness and recovery of muscle strength and power following a marathon. Discussion/Conclusion: Though there was no consensus in terms of WBC’s effectiveness at treating exercise-induced muscle damage following running compared to other interventions, it seems as though WBC may at least have a time-dependent positive effect on muscle soreness and recovery following high-intensity interval runs and endurance running, marathons excluded. More research needs to be conducted in order to determine the most effective way to implement WBC as a recovery method for exercise-induced muscle damage, including the optimal temperature, timing, duration, and frequency of treatment.

Keywords: cryotherapy, physical therapy intervention, physical therapy, whole body cryotherapy

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Authors: Salvana P. M. Costa, Tarcyla A. Gomes, Giovanna C. R. M. Schver, Leslie R. M. Ferraz, Cristovão R. Silva, Magaly A. M. Lyra, Danilo A. F. Fonte, Larissa A. Rolim, Amanda C. Q. M. Vieira, Miracy M. Albuquerque, Pedro J. Rolim-neto

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Efavirenz (EFV) is considered one of the most widely used anti-HIV drugs. However, it is classified as a drug class II (poorly soluble, highly permeable) according to the biopharmaceutical classification system, presenting problems of absorption in the gastrointestinal tract and thereby inadequate bioavailability for its therapeutic action. This study aimed to overcome these barriers by developing and obtaining solid dispersions (SD) in order to increase the EFZ bioavailability. For the development of SD with EFV, theoretical and practical studies were initially performed. Thus, there was a choice of a carrier to be used. For this, it was analyzed the various criteria such as glass transition temperature of the polymer, intra- and intermolecular interactions of hydrogen bonds between drug and polymer, the miscibility between the polymer and EFV. The choice of the obtainment method of the SD came from the analysis of which method is the most consolidated in both industry and literature. Subsequently, the choice of drug and carrier concentrations in the dispersions was carried out. In order to obtain DS to present the drug in its amorphous form, as the DS were obtained, they were analyzed by X-ray diffraction (XRD). SD are more stable the higher the amount of polymer present in the formulation. With this assumption, a SD containing 10% of drug was initially prepared and then this proportion was increased until the XRD showed the presence of EFV in its crystalline form. From this point, it was not produced SD with a higher concentration of drug. Thus, it was allowed to select PVP-K30, PVPVA 64 and the SOLUPLUS formulation as carriers, once it was possible the formation of hydrogen bond between EFV and polymers since these have hydrogen acceptor groups capable of interacting with the donor group of the drug hydrogen. It is worth mentioning also that the films obtained, independent of concentration used, were presented homogeneous and transparent. Thus, it can be said that the EFV is miscible in the three polymers used in the study. The SD and Physical Mixtures (PM) with these polymers were prepared by the solvent method. The EFV diffraction profile showed main peaks at around 2θ of 6,24°, in addition to other minor peaks at 14,34°, 17,08°, 20,3°, 21,36° and 25,06°, evidencing its crystalline character. Furthermore, the polymers showed amorphous nature, as evidenced by the absence of peaks in their XRD patterns. The XRD patterns showed the PM overlapping profile of the drug with the polymer, indicating the presence of EFV in its crystalline form. Regardless the proportion of drug used in SD, all the samples showed the same characteristics with no diffraction peaks EFV, demonstrating the behavior amorphous products. Thus, the polymers enabled, effectively, the formation of amorphous SD, probably due to the potential hydrogen bonds between them and the drug. Moreover, the XRD analysis showed that the polymers were able to maintain its amorphous form in a concentration of up to 80% drug.

Keywords: amorphous form, Efavirenz, solid dispersions, solubility

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Authors: Magda Milleyde de Sousa Lima, Letícia Lima Aguiar, Marina Guerra Martins, Erika Veríssimo Dias Sousa, Lizandra Sampaio de Oliveira, Lívia Moreira Barros, Joselany Áfio Caetano

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Patients with chronic kidney disease are vulnerable to episodes which make the safety of their health vulnerable, mainly due to the treatment process that exposes them to high rates of interventions during hemodialysis sessions. Some factors associated with health care contribute to the risk of death and complications. However, there are a small number of scientific studies evaluating the level of safety of hemodialysis clinics, and the sociodemographic characteristics of patients and professionals associated with this safety. Therefore, the present study aims to examine the level of patient safety in hemodialysis clinics in the Brazilian capital, to identify the sociodemographic and clinical factors of patients and nursing staff associated with the level of safety. This is an observational, descriptive and quantitative research conducted in three hemodialysis clinics placed in the city of Fortaleza-CE, Brazil, from September to November 2019. The sample was formed after a sample calculation for finite inhabitants of correlation with 200 chronic renal patients, 30 nursing technicians and seven nurses. Conventional sampling was used based on the inclusion criteria: being present at the hemodialysis session on the day the researcher performed the data collection and being 18 years of age or older. Participants who presented communication difficulties to listen to and/or answer the sociodemographic and clinical questionnaire were excluded. Two instruments were applied: sociodemographic and clinical characterization form and Chronic Renal Patient Safety Assessment Scale on Hemodialysis (EASPRCH). The data were analyzed using the Kruskal Walls Test for categorical variables and Spearman correlation coefficient for non-categorical variables, using the Statistical Package SPSS version 20.0. The present study respected the ethical and legal principles determined by resolution 466/2012 of the National Health Council, under the approval of the Ethics and Research Committee with an opinion number: 3,255,635. The results showed that a hemodialysis clinic presented unsafe care practices of 32 points in the EASPRCH (p=0.001). A statistical association was identified between the level of safety and the variables of the patients: level of education (p=0.018), family income (p=0.049), type of employment (p=0.012), venous access site (p=0.009), use of medication during the session (p=0.008) and time of hemodialysis (p=0.002). When evaluating the profile of nurses, a statistical association was evidenced between the level of safety with the variables: marital status (p=0.000), race (p=0.017), schooling (p= 0.000), income (p=0.013), age (p=0.000), clinic workload (p=0.000), time working with hemodialysis (p=0.000), time working in the clinic (p= 0.007) and clinic sizing (p=0.000). In order, the sociodemographic factors of nursing technicians associated with the level of patient safety were: race (p= 0.001) and weekly workload at (p=0.010). Therefore, it is concluded that there is a non-conformity in the level of patient safety in one of the clinics studied and, that sociodemographic and clinical factors of patients and health professionals corroborate the level of safety of the health unit.

Keywords: hemodialysis, nursing, patient safety, quality improvement

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Authors: Pedro G. Morouço

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One utmost challenge in Tissue Engineering is the production of 3D constructs capable of mimicking the functional hierarchy of native tissues. This is well stated for osteochondral tissue due to the complex mechanical functional unit based on the junction of articular cartilage and bone. Thus, the aim of the present study was to develop a new additive manufacturing system coupling micro-extrusion with hydrogels printing. An integrated system was developed with 2 main features: (i) the printing of up to three distinct hydrogels; (ii) in coordination with the printing of a thermoplastic structural support. The hydrogel printing module was projected with a ‘revolver-like’ system, where the hydrogel selection was made by a rotating mechanism. The hydrogel deposition was then controlled by pressured air input. The use of specific components approved for medical use was incorporated in the material dispensing system (Nordson EDF Optimum® fluid dispensing system). The thermoplastic extrusion modulus enabled the control of required extrusion temperature through electric resistances in the polymer reservoir and the extrusion system. After testing and upgrades, a hydrogel modulus with 3 syringes (3cm3 capacity each), with a pressure range of 0-2.5bar, a rotational speed of 0-5rpm, and working with needles from 200-800µm was obtained. This modulus was successfully coupled to the extrusion system that presented a temperature up to 300˚C, a pressure range of 0-12bar, and working with nozzles from 200-500µm. The applied motor could provide a velocity range 0-2000mm/min. Although, there are distinct printing requirements for hydrogels and polymers, the novel system could develop hybrid scaffolds, combining the 2 moduli. The morphological analysis showed high reliability (n=5) between the theoretical and obtained filament and pore size (350µm and 300µm vs. 342±4µm and 302±3µm, p>0.05, respectively) of the polymer; and multi-material 3D constructs were successfully obtained. Human tissues present very distinct and complex structures regarding their mechanical properties, organization, composition and dimensions. For osteochondral regenerative medicine, a multiphasic scaffold is required as subchondral bone and overlying cartilage must regenerate at the same time. Thus, a scaffold with 3 layers (bone, intermediate and cartilage parts) can be a promising approach. The developed system may give a suitable solution to construct those hybrid scaffolds with enhanced properties. The present novel system is a step-forward regarding osteochondral tissue engineering due to its ability to generate layered mechanically stable implants through the double-printing of hydrogels with thermoplastics.

Keywords: 3D bioprinting, bone regeneration, cartilage regeneration, regenerative medicine, tissue engineering

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Authors: S. Dias, A. Tadeu, J. Antonio, F. Pedro, C. Serra

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The goal of the present work is to experimentally evaluate the feasibility of using vibration isolators made of expanded cork agglomerate. Even though this material, also known as insulation cork board (ICB), has mainly been studied for thermal and acoustic insulation purposes, it has strong potential for use in vibration isolation. However, the adequate design of expanded cork blocks vibration isolators will depend on several factors, such as excitation frequency, static load conditions and intrinsic dynamic behavior of the material. In this study, transmissibility tests for different static and dynamic loading conditions were performed in order to characterize the material. Since the material’s physical properties can influence the vibro-isolation performance of the blocks (in terms of density and thickness), this study covered four mass density ranges and four block thicknesses. A total of 72 expanded cork agglomerate specimens were tested. The test apparatus comprises a vibration exciter connected to an excitation mass that holds the test specimen. The test specimens under characterization were loaded successively with steel plates in order to obtain results for different masses. An accelerometer was placed at the top of these masses and at the base of the excitation mass. The test was performed for a defined frequency range, and the amplitude registered by the accelerometers was recorded in time domain. For each of the signals (signal 1- vibration of the excitation mass, signal 2- vibration of the loading mass) a fast Fourier transform (FFT) was applied in order to obtain the frequency domain response. For each of the frequency domain signals, the maximum amplitude reached was registered. The ratio between the amplitude (acceleration) of signal 2 and the amplitude of signal 1, allows the calculation of the transmissibility for each frequency. Repeating this procedure allowed us to plot a transmissibility curve for a certain frequency range. A number of transmissibility experiments were performed to assess the influence of changing the mass density and thickness of the expanded cork blocks and the experimental conditions (static load and frequency of excitation). The experimental transmissibility tests performed in this study showed that expanded cork agglomerate blocks are a good option for mitigating vibrations. It was concluded that specimens with lower mass density and larger thickness lead to better performance, with higher vibration isolation and a larger range of isolated frequencies. In conclusion, the study of the performance of expanded cork agglomerate blocks presented herein will allow for a more efficient application of expanded cork vibration isolators. This is particularly relevant since this material is a more sustainable alternative to other commonly used non-environmentally friendly products, such as rubber.

Keywords: expanded cork agglomerate, insulation cork board, transmissibility tests, sustainable materials, vibration isolators

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Authors: Jose Daniel Braga Alves, Joaquim Gois, Alexandre Leite

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This abstract presents the responsible and sustainable mining case study of a Portuguese mine operation, highlighting how mine exploitation can sustainably exist in balance with the environment, aligned with all stakeholders. The mining operation is remotely located in a United Nations (UN) biodiversity reserve, away from major industrial centers or logistical ports, and presents an interesting investigation to assess the balanced mine operation in alignment with all key stakeholders, which presents unique opportunities as well as challenges. Based on the sustainable mining framework, it is intended to detail examples of best practices from Sociedade Mineira de Neves-Corvo (SOMINCOR), demonstrating social acceptance by the local community, health, and safety at work, reduction of environmental impacts and management of mining waste, which directly influence the acceptance and recognition of a sustainable operation. The case study aims to present the SOMINCOR approach to sustainable mining, focusing on social responsibility, considering materials provided by Lundin Mining Corporation (LMC) and SOMINCOR and the socially responsible approach of the mining operations., referencing related international guidelines, UN Sustainable Development Goals. The researchers reviewed LMC's annual Sustainability Reports (2019, 2020 and 2021) and updated information regarding material topics of the most significant interest to internal and external stakeholders. These material topics formed the basis of the corporation-wide sustainability strategy. LMC's Responsible Mining Policy (RMP) was reviewed, focusing on the commitment that guides the approach to responsible operation and management of the Company's business. Social performance, compliance, environmental management, governance, human rights, and economic contribution are principles of the RMP. The Human Rights Risk Impact Assessment (HRRIA), based on frameworks including UN Guiding Principles (UNGP), Voluntary Principles on Security and Human Rights, and a community engagement program implemented (SLO index), was part of this research. The program consists of ongoing surveys and perceptions studies using behavioural science insights, data from which was not available within the timeframe of completing this research. LMC stakeholder engagement standards and grievance mechanisms were also reviewed. Stakeholder engagement and the community's perception are key to this operation to ensure social license to operate (SLO). Preliminary surveys with local communities provided input data for the local development strategy. After the implementation of several initiatives, subsequent surveys were performed to assess acceptance and trust from the local communities and changes to the SLO index. SOMINCOR's operation contributes to 12 out of 17 sustainable development goals. From the assessed and available data, local communities and social engagement are priorities to SOMINCOR. Experience to date shows that the continual engagement with local communities and the grievance mechanisms in place are respected and followed for all concerns presented by any stakeholder. It can be concluded that this underground mine in Portugal complies with applicable regulations and goes beyond them with regard to sustainable development and engagement with key stakeholders.

Keywords: sustainable mining, development goals, portuguese mining, zinc copper

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Authors: Benito Minjarez, Jesse Haramati, Yury Rodriguez-Yanez, Florencio Recendiz-Hurtado, Juan-Pedro Luna-Arias, Salvador Mena-Munguia

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During the last decades, the world has experienced a rapid industrialization and an expanding economy favoring a demographic boom. As a consequence, countries around the world have focused on developing new strategies related to the production of different farm products in order to meet future demands. Consequently, different strategies have been developed seeking to improve the major food products for both humans and livestock. Corn, after wheat and rice, is the third most important crop globally and is the primary food source for both humans and livestock in many regions around the globe. In addition, maize (Zea mays) is an important source of protein accounting for up to 60% of the daily human protein supply. Generally, many of the cereal grains have proteins with relatively low nutritional value, when they are compared with proteins from meat. In the case of corn, much of the protein is found in the endosperm (75 to 85%) and is deficient in two essential amino acids, lysine, and tryptophan. This deficiency results in an imbalance of amino acids and low protein content; normal maize varieties have less than half of the recommended amino acids for human nutrition. In addition, studies have shown that this deficiency has been associated with symptoms of growth impairment, anemia, hypoproteinemia, and fatty liver. Due to the fact that most of the presently available maize varieties do not contain the quality and quantity of proteins necessary for a balanced diet, different countries have focused on the research of quality protein maize (QPM). Researchers have characterized QPM noting that these varieties may contain between 70 to 100% more residues of the amino acids essential for animal and human nutrition, lysine, and tryptophan, than common corn. Several countries in Africa, Latin America, as well as China, have incorporated QPM in their agricultural development plan. Large parts of these countries have chosen a specific QPM variety based on their local needs and climate. Reviews have described the breeding methods of maize and have revealed the lack of studies on genetic and proteomic diversity of proteins in QPM varieties, and their genetic relationships with normal maize varieties. Therefore, molecular marker identification using tools such as mass spectrometry may accelerate the selection of plants that carry the desired proteins with high lysine and tryptophan concentration. To date, QPM maize lines have played a very important role in alleviating the malnutrition, and better characterization of these lines would provide a valuable nutritional enhancement for use in the resource-poor regions of the world. Thus, the objectives of this study were to identify proteins in QPM maize in comparison with a common maize line as a control.

Keywords: corn, mass spectrometry, QPM, tryptophan

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Authors: Pedro J. Rolim-Neto, Leslie R. M. Ferraz, Fabiana L. A. Santos, Pablo A. Ferreira, Ricardo T. L. Maia-Jr., Magaly A. M. Lyra, Danilo A F. Fonte, Salvana P. M. Costa, Amanda C. Q. M. Vieira, Larissa A. Rolim

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Initially developed as an antimalarial agent, hydroxychloroquine (HCQ) sulfate is often used as a slow-acting antirheumatic drug in the treatment of disorders of connective tissue. The United States Pharmacopeia (USP) 37 provides a reversed-phase HPLC method for quantification of HCQ. However, this method was not reproducible, producing asymmetric peaks in a long analysis time. The asymmetry of the peak may cause an incorrect calculation of the concentration of the sample. Furthermore, the analysis time is unacceptable, especially regarding the routine of a pharmaceutical industry. The aiming of this study was to develop a fast, easy and efficient method for quantification of HCQ sulfate by High Performance Liquid Chromatography (HPLC) based on the Quality by Design (QbD) methodology. This method was optimized in terms of peak symmetry using the surface area graphic as the Design of Experiments (DoE) and the tailing factor (TF) as an indicator to the Design Space (DS). The reference method used was that described at USP 37 to the quantification of the drug. For the optimized method, was proposed a 33 factorial design, based on the QbD concepts. The DS was created with the TF (in a range between 0.98 and 1.2) in order to demonstrate the ideal analytical conditions. Changes were made in the composition of the USP mobile-phase (USP-MP): USP-MP: Methanol (90:10 v/v, 80:20 v/v and 70:30 v/v), in the flow (0.8, 1.0 and 1.2 mL) and in the oven temperature (30, 35, and 40ºC). The USP method allowed the quantification of drug in a long time (40-50 minutes). In addition, the method uses a high flow rate (1,5 mL.min-1) which increases the consumption of expensive solvents HPLC grade. The main problem observed was the TF value (1,8) that would be accepted if the drug was not a racemic mixture, since the co-elution of the isomers can become an unreliable peak integration. Therefore, the optimization was suggested in order to reduce the analysis time, aiming a better peak resolution and TF. For the optimization method, by the analysis of the surface-response plot it was possible to confirm the ideal setting analytical condition: 45 °C, 0,8 mL.min-1 and 80:20 USP-MP: Methanol. The optimized HPLC method enabled the quantification of HCQ sulfate, with a peak of high resolution, showing a TF value of 1,17. This promotes good co-elution of isomers of the HCQ, ensuring an accurate quantification of the raw material as racemic mixture. This method also proved to be 18 times faster, approximately, compared to the reference method, using a lower flow rate, reducing even more the consumption of the solvents and, consequently, the analysis cost. Thus, an analytical method for the quantification of HCQ sulfate was optimized using QbD methodology. This method proved to be faster and more efficient than the USP method, regarding the retention time and, especially, the peak resolution. The higher resolution in the chromatogram peaks supports the implementation of the method for quantification of the drug as racemic mixture, not requiring the separation of isomers.

Keywords: analytical method, hydroxychloroquine sulfate, quality by design, surface area graphic

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Authors: Cátia Gonçalves, Teresa Nunes, Inês Pina, Ana Vicente, C. Alves, Felix Charvet, Daniel Neves, A. Matos

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The production of charcoal relies on rudimentary technologies using traditional brick kilns. Charcoal is produced under pyrolysis conditions: breaking down the chemical structure of biomass under high temperature in the absence of air. The amount of the pyrolysis products (charcoal, pyroligneous extract, and flue gas) depends on various parameters, including temperature, time, pressure, kiln design, and wood characteristics like the moisture content. This activity is recognized for its inefficiency and high pollution levels, but it is poorly characterized. This activity is widely distributed and is a vital economic activity in certain regions of Portugal, playing a relevant role in the management of woody residues. The location of the units establishes the biomass used for charcoal production. The Portalegre district, in the Alto Alentejo region (Portugal), is a good example, essentially with rural characteristics, with a predominant farming, agricultural, and forestry profile, and with a significant charcoal production activity. In this district, a recent inventory identifies almost 50 charcoal production units, equivalent to more than 450 kilns, of which 80% appear to be in operation. A field campaign was designed with the objective of determining the composition of the emissions released during a charcoal production cycle. A total of 30 samples of particulate matter and 20 gas samples in Tedlar bags were collected. Particulate and gas samplings were performed in parallel, 2 in the morning and 2 in the afternoon, alternating the inlet heads (PM₁₀ and PM₂.₅), in the particulate sampler. The gas and particulate samples were collected in the plume as close as the emission chimney point. The biomass (dry basis) used in the carbonization process was a mixture of cork oak (77 wt.%), holm oak (7 wt.%), stumps (11 wt.%), and charred wood (5 wt.%) from previous carbonization processes. A cylindrical batch kiln (80 m³) with 4.5 m diameter and 5 m of height was used in this study. The composition of the gases was determined by gas chromatography, while the particulate samples (PM₁₀, PM₂.₅) were subjected to different analytical techniques (thermo-optical transmission technique, ion chromatography, HPAE-PAD, and GC-MS after solvent extraction) after prior gravimetric determination, to study their organic and inorganic constituents. The charcoal production cycle presents widely varying operating conditions, which will be reflected in the composition of gases and particles produced and emitted throughout the process. The concentration of PM₁₀ and PM₂.₅ in the plume was calculated, ranging between 0.003 and 0.293 g m⁻³, and 0.004 and 0.292 g m⁻³, respectively. Total carbon, inorganic ions, and sugars account, in average, for PM10 and PM₂.₅, 65 % and 56 %, 2.8 % and 2.3 %, 1.27 %, and 1.21 %, respectively. The organic fraction studied until now includes more than 30 aliphatic compounds and 20 PAHs. The emission factors of particulate matter to produce charcoal in the traditional kiln were 33 g/kg (wooddb) and 27 g/kg (wooddb) for PM₁₀ and PM₂.₅, respectively. With the data obtained in this study, it is possible to fill the lack of information about the environmental impact of the traditional charcoal production in Portugal. Acknowledgment: Authors thanks to FCT – Portuguese Science Foundation, I.P. and to Ministry of Science, Technology and Higher Education of Portugal for financial support within the scope of the project CHARCLEAN (PCIF/GVB/0179/2017) and CESAM (UIDP/50017/2020 + UIDB/50017/2020).

Keywords: brick kilns, charcoal, emission factors, PAHs, total carbon

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Authors: João Pedro Zanella, Michel J. O. Fagundes

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Introduction: Drug use has been practised by humans universally for millennia, not excluding any population from these habits, however, the rampant drug use is a global concern due to the harm that affects the health of the world population. In this sense, it is observed the reduction of lasting and effective public policies for the resolution, increasing the demand for treatment services. With this comes ibogaine, an alkaloid derived from the root of an African bush (Tabernanthe Iboga), found mostly in Gabon and used widely by the native Bwiti population in rituals, and also other social groups, which demonstrates efficacy against chemical dependence, psychic and emotional disorders, opioid withdrawal was first confirmed by a study in rats done by Michailo Dzoljic and associates in 1988 and again in 1994. Methods: A brief description of the plant, its neurohumoral potential and the effects caused by ingested doses, in a simplified and objective way, will be discussed in the course of this abstract. Results: Ibogaine is not registered or passed by Anvisa, regarding safety and efficacy, and cannot be sold in Brazil. Its illegal trade reaches R$ 5 thousand for a session with the proceeds of the root, and its effect can last up to 72 hours, attributing Iboga's psychoactive effects to the alkaloid called ibogaine. The shrub where Ibogaine is located has pink and yellow flowers, and its fruit produced does not have psychoactive substances, but its root bark contains 6 to 7% indolic alkaloids. Besides extraction from the iboga plant, ibogaine hydrochloride can be semisynthesized from voacangine, another plant alkaloid that acts as a precursor. Its potential has the ability to perform multiple interactions with the neurotransmitter system, which are closely associated with addiction, including nicotinic, opioid and serotoninergic systems. Studies carried out by Edwards found that the doses administered of Iboga should be determined by a health professional when its purpose is to treat individuals for dependence on other drugs. Its use in small doses may cause an increase in sensibility, impaired vision and motor alterations; in moderate quantities, hallucinations, motor and neurological alterations and impaired vision; in high quantities it may cause hallucinations with personal events at a deeper level lasting up to 24 hours or more, followed by motor and visual alterations. Conclusion: The product extracted from the Iboga plant is of great importance in controlling addiction, reducing the need for the use of narcotics by patients, thus gaining a space of extreme importance in the treatment of users of psychoactive substances. It is remarkable the progress of the latest’s research about the usefulness of Ibogaine, and its benefits for certain treatments, even with the restriction of its sale in Brazil. Besides this, Ibogaine has an additional benefit of helping the patient to gain self-control over their destructive behaviours.

Keywords: alkaloids, dependence, Gabon, ibogaine

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Authors: Caroline Lavratti, Pedro Dal Lago, Gustavo Reinaldo, Gilson Dorneles, Andreia Bard, Laira Fuhr, Daniela Pochmann, Alessandra Peres, Luciane Wagner, Viviane Elsner

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Approximately 1% of the world's population is affected by schizophrenia (SZ), a chronic and debilitating neurodevelopmental disorder. Among possible factors, reduced levels of Brain-derived neurotrophic factor (BDNF) has been recognized in physiopathogenesis and course of SZ. In this context, peripheral BDNF levels have been used as a biomarker in several clinical studies, since this neurotrophin is able to cross the blood-brain barrier in a bi-directional manner and seems to present a strong correlation with the central nervous system fluid levels. The patients with SZ usually adopts a sedentary lifestyle, which has been partly associated with the increase in obesity incidence rates, metabolic syndrome, type 2 diabetes and coronary heart disease. On the other hand, exercise, a non-invasive and low cost intervention, has been considered an important additional therapeutic option for this population, promoting benefits to physical and mental health. To our knowledge, few studies have been pointed out that the positive effects of exercise in SZ patients are mediated, at least in part, to enhanced levels of BDNF after training. However, these studies are focused on evaluating the effect of single bouts of exercise of chronic interventions, data concerning the short- and long-term exercise outcomes on BDNF are scarce. Therefore, this study aimed to evaluate the effect of a concurrent exercise protocol (CEP) on plasma BDNF levels of SZ patients in different time-points. Material and Methods: This study was approved by the Research Ethics Committee of the Centro Universitário Metodista do IPA (no 1.243.680/2015). The participants (n=15) were subbmited to the CEP during 90 days, 3 times a week for 60 minutes each session. In order to evaluate the short and long-term effects of exercise, blood samples were collected pre, 30, 60 and 90 days after the intervention began. Plasma BDNF levels were determined with the ELISA method, from Sigma-Aldrich commercial kit (catalog number RAB0026) according to manufacturer's instructions. Results: A remarkable increase on plasma BDNF levels at 90 days after training compared to baseline (p=0.006) and 30 days (p=0.007) values were observed. Conclusion: Our data are in agreement with several studies that show significant enhancement on BDNF levels in response to different exercise protocols in SZ individuals. We might suggest that BDNF upregulation after training in SZ patients acts in a dose-dependent manner, being more pronounced in response to chronic exposure. Acknowledgments: This work was supported by Fundação de Amparo à Pesquisa do Estado do Rio Grande do Sul (FAPERGS)/Brazil.

Keywords: exercise, BDNF, schizophrenia, time-points

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Authors: Alberto Azevedo, Ricardo Martins, André B. Fortunato, Anabela Oliveira

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Water is under severe threat today because of the rising population, increased agricultural and industrial needs, and the intensifying effects of climate change. Due to sea-level rise, erosion, and demographic pressure, the coastal regions are of significant concern to the scientific community. The Water Monitoring Sentinel Cloud platform (WORSICA) service is focused on providing new tools for monitoring water in coastal and inland areas, taking advantage of remote sensing, in situ and tidal modeling data. WORSICA is a service that can be used to determine the coastline, coastal inundation areas, and the limits of inland water bodies using remote sensing (satellite and Unmanned Aerial Vehicles - UAVs) and in situ data (from field surveys). It applies to various purposes, from determining flooded areas (from rainfall, storms, hurricanes, or tsunamis) to detecting large water leaks in major water distribution networks. This service was built on components developed in national and European projects, integrated to provide a one-stop-shop service for remote sensing information, integrating data from the Copernicus satellite and drone/unmanned aerial vehicles, validated by existing online in-situ data. Since WORSICA is operational using the European Open Science Cloud (EOSC) computational infrastructures, the service can be accessed via a web browser and is freely available to all European public research groups without additional costs. In addition, the private sector will be able to use the service, but some usage costs may be applied, depending on the type of computational resources needed by each application/user. Although the service has three main sub-services i) coastline detection; ii) inland water detection; iii) water leak detection in irrigation networks, in the present study, an application of the service to Óbidos lagoon in Portugal is shown, where the user can monitor the evolution of the lagoon inlet and estimate the topography of the intertidal areas without any additional costs. The service has several distinct methodologies implemented based on the computations of the water indexes (e.g., NDWI, MNDWI, AWEI, and AWEIsh) retrieved from the satellite image processing. In conjunction with the tidal data obtained from the FES model, the system can estimate a coastline with the corresponding level or even topography of the inter-tidal areas based on the Flood2Topo methodology. The outcomes of the WORSICA service can be helpful for several intervention areas such as i) emergency by providing fast access to inundated areas to support emergency rescue operations; ii) support of management decisions on hydraulic infrastructures operation to minimize damage downstream; iii) climate change mitigation by minimizing water losses and reduce water mains operation costs; iv) early detection of water leakages in difficult-to-access water irrigation networks, promoting their fast repair.

Keywords: remote sensing, coastline detection, water detection, satellite data, sentinel, Copernicus, EOSC

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Authors: Lya Porto, Giulia Giacchè, Mario Aquino Alves

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The paper aims to describe the linkage between government and civil society proposing a study on agro-ecological agriculture policy and urban action in São Paulo city underling the main achievements obtained. The negotiation processes between social movements and the government (inputs) and its results on political regulation and public action for Urban Agriculture (UA) in São Paulo city (outputs) have been investigated. The method adopted is qualitative, with techniques of semi-structured interviews, participant observation, and documental analysis. The authors conducted 30 semi-structured interviews with organic farmers, activists, governmental and non-governmental managers. Participant observation was conducted in public gardens, urban farms, public audiences, democratic councils, and social movements meetings. Finally, public plans and laws were also analyzed. São Paulo city with around 12 million inhabitants spread out in a 1522 km2 is the economic capital of Brazil, marked by spatial and socioeconomic segregation, currently aggravated by environmental crisis, characterized by water scarcity, pollution, and climate changes. In recent years, Urban Agriculture (UA) social movements gained strength and struggle for a different city with more green areas, organic food production, and public occupation. As the dynamics of UA occurs by the action of multiple actresses and institutions that struggle to build multiple senses on UA, the analysis will be based on literature about solidarity economy, governance, public action and networks. Those theories will mark out the analysis that will emphasize the approach of inter-subjectivity built between subjects, as well as the hybrid dynamics of multiple actors and spaces in the construction of policies for UA. Concerning UA we identified four main typologies based on land ownership, main function (economic or activist), form of organization of the space, and type of production (organic or not). The City Hall registers 500 productive unities of agriculture, with around 1500 producers, but researcher estimated a larger number of unities. Concerning the social movements we identified three categories that differ in goals and types of organization, but all of them work by networks of activists and/or organizations. The first category does not consider themselves as a movement, but a network. They occupy public spaces to grow organic food and to propose another type of social relations in the city. This action is similar to what became known as the green guerrillas. The second is configured as a movement that is structured to raise awareness about agro-ecological activities. The third one is a network of social movements, farmers, organizations and politicians that work focused on pressure and negotiation with executive and legislative government to approve regulations and policies on organic and agro-ecological Urban Agriculture. We conclude by highlighting how the interaction among institutions and civil society produced important achievements for recognition and implementation of UA within the city. Some results of this process are awareness for local production, legal and institutional recognition of the rural zone around the city into the planning tool, the investment on organic school public procurements, the establishment of participatory management of public squares, the inclusion of UA on Municipal Strategic Plan and Master Plan.

Keywords: public action, policies, agroecology, urban and peri-urban agriculture, Sao Paulo

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Authors: Hanan Algarni

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Background: Impairment of walking and balance skills has negative impact on functional independence and community participation after stroke. Gait recovery is considered a primary goal in rehabilitation by both patients and physiotherapists. Treadmill training coupled with virtual reality technology is a new emerging approach that offers patients with feedback, open and random skills practice while walking and interacting with virtual environmental scenes. Objectives: To synthesize the evidence around the effects of the VR treadmill training on gait speed and balance primarily, functional independence and community participation secondarily in stroke patients. Methods: Systematic review was conducted; search strategy included electronic data bases: MEDLINE, AMED, Cochrane, CINAHL, EMBASE, PEDro, Web of Science, and unpublished literature. Inclusion criteria: Participant: adult >18 years, stroke, ambulatory, without severe visual or cognitive impartments. Intervention: VR treadmill training alone or with physiotherapy. Comparator: any other interventions. Outcomes: gait speed, balance, function, community participation. Characteristics of included studies were extracted for analysis. Risk of bias assessment was performed using Cochrane's ROB tool. Narrative synthesis of findings was undertaken and summary of findings in each outcome was reported using GRADEpro. Results: Four studies were included involving 84 stroke participants with chronic hemiparesis. Interventions intensity ranged (6-12 sessions, 20 minutes-1 hour/session). Three studies investigated the effects on gait speed and balance. 2 studies investigated functional outcomes and one study assessed community participation. ROB assessment showed 50% unclear risk of selection bias and 25% of unclear risk of detection bias across the studies. Heterogeneity was identified in the intervention effects at post training and follow up. Outcome measures, training intensity and durations also varied across the studies, grade of evidence was low for balance, moderate for speed and function outcomes, and high for community participation. However, it is important to note that grading was done on few numbers of studies in each outcome. Conclusions: The summary of findings suggests positive and statistically significant effects (p<0.05) of VR treadmill training compared to other interventions on gait speed, dynamic balance skills, function and participation directly after training. However, the effects were not sustained at follow up in two studies (2 weeks-1 month) and other studies did not perform follow up measurements. More RCTs with larger sample sizes and higher methodological quality are required to examine the long term effects of VR treadmill effects on function independence and community participation after stroke, in order to draw conclusions and produce stronger robust evidence.

Keywords: virtual reality, treadmill, stroke, gait rehabilitation

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Authors: Sonia Butalia, Huong Luu, Alexis Guigue, Karen J. B. Martins, Khanh Vu, Scott W. Klarenbach

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Obesity is associated with significant personal impacts on health and has a substantial economic burden on payers due to increased healthcare use. A contemporary estimate of the healthcare costs associated with obesity at the population level are lacking. This evidence may provide further rationale for weight management strategies. Methods: Adults who underwent a medical procedure between 2012 and 2019 in Alberta, Canada were categorized into the investigational cohort (had body mass index [BMI]-defined class 2 or 3 obesity based on a procedure-associated code) and the control cohort (did not have the BMI procedure-associated code); those who had bariatric surgery were excluded. Characteristics were presented and healthcare costs ($CDN) determined over a 1-year observation period (2019/2020). Logistic regression and a generalized linear model with log link and gamma distribution were used to assess total healthcare costs (comprised of hospitalizations, emergency department visits, ambulatory care visits, physician visits, and outpatient prescription drugs); potential confounders included age, sex, region of residence, and whether the medical procedure was performed within 6-months before the observation period in the partial adjustment, and also the type of procedure performed, socioeconomic status, Charlson Comorbidity Index (CCI), and seven obesity-related health conditions in the full adjustment. Cost ratios and estimated cost differences with 95% confidence intervals (CI) were reported; incremental cost differences within the adjusted models represent referent cases. Results: The investigational cohort (n=220,190) was older (mean age: 53 standard deviation [SD]±17 vs 50 SD±17 years), had more females (71% vs 57%), lived in rural areas to a greater extent (20% vs 14%), experienced a higher overall burden of disease (CCI: 0.6 SD±1.3 vs 0.3 SD±0.9), and were less socioeconomically well-off (material/social deprivation was lower [14%/14%] in the most well-off quintile vs 20%/19%) compared with controls (n=1,955,548). Unadjusted total healthcare costs were estimated to be 1.77-times (95% CI: 1.76, 1.78) higher in the investigational versus control cohort; each healthcare resource contributed to the higher cost ratio. After adjusting for potential confounders, the total healthcare cost ratio decreased, but remained higher in the investigational versus control cohort (partial adjustment: 1.57 [95% CI: 1.57, 1.58]; full adjustment: 1.21 [95% CI: 1.20, 1.21]); each healthcare resource contributed to the higher cost ratio. Among urban-dwelling 50-year old females who previously had non-operative procedures, no procedures performed within 6-months before the observation period, a social deprivation index score of 3, a CCI score of 0.32, and no history of select obesity-related health conditions, the predicted cost difference between those living with and without obesity was $386 (95% CI: $376, $397). Conclusions: If these findings hold for the Canadian population, one would expect an estimated additional $3.0 billion per year in healthcare costs nationally related to BMI-defined obesity (based on an adult obesity rate of 26% and an estimated annual incremental cost of $386 [21%]); incremental costs are higher when obesity-related health conditions are not adjusted for. Results of this study provide additional rationale for investment in interventions that are effective in preventing and treating obesity and its complications.

Keywords: administrative data, body mass index-defined obesity, healthcare cost, real world evidence

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Authors: Pedro B. Antunes, Paulo J. Ramísio

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Road runoff is a linear source of diffuse pollution that can cause significant environmental impacts. During rainfall events, pollutants from both stationary and mobile sources, which have accumulated on the road surface, are dragged through the superficial runoff. Road runoff in coastal zones may present high levels of salinity and chlorides due to the proximity of the sea and transported marine aerosols. Appearing to be correlated to this process, organic matter concentration may also be significant. This study assesses this phenomenon with the purpose of identifying the relationships between monitored water quality parameters and intrinsic site variables. To achieve this objective, an extensive monitoring program was conducted on a Portuguese coastal highway. The study included thirty rainfall events, in different weather, traffic and salt deposition conditions in a three years period. The evaluations of various water quality parameters were carried out in over 200 samples. In addition, the meteorological, hydrological and traffic parameters were continuously measured. The salt deposition rates (SDR) were determined by means of a wet candle device, which is an innovative feature of the monitoring program. The SDR, variable throughout the year, appears to show a high correlation with wind speed and direction, but mostly with wave propagation, so that it is lower in the summer, in spite of the favorable wind direction in the case study. The distance to the sea, topography, ground obstacles and the platform altitude seems to be also relevant. It was confirmed the high salinity in the runoff, increasing the concentration of the water quality parameters analyzed, with significant amounts of seawater features. In order to estimate the correlations and patterns of different water quality parameters and variables related to weather, road section and salt deposition, the study included exploratory data analysis using different techniques (e.g. Pearson correlation coefficients, Cluster Analysis and Principal Component Analysis), confirming some specific features of the investigated road runoff. Significant correlations among pollutants were observed. Organic matter was highlighted as very dependent of salinity. Indeed, data analysis showed that some important water quality parameters could be divided into two major clusters based on their correlations to salinity (including organic matter associated parameters) and total suspended solids (including some heavy metals). Furthermore, the concentrations of the most relevant pollutants seemed to be very dependent on some meteorological variables, particularly the duration of the antecedent dry period prior to each rainfall event and the average wind speed. Based on the results of a monitoring case study, in a coastal zone, it was proven that SDR, associated with the hydrological characteristics of road runoff, can contribute for a better knowledge of the runoff characteristics, and help to estimate the specific nature of the runoff and related water quality parameters.

Keywords: coastal zones, monitoring, road runoff pollution, salt deposition

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