Overview of Ethnobotanical-Pharmacological Studies Carried Out on Medicinal Plants from the Serra da Estrela Natural Park: Focus on Their Antidiabetic Potential

The Serra da Estrela Natural Park (NPSE) in Portugal stands out as a well-preserved region abundant in medicinal plants, particularly known for their pharmaceutical applications in diabetes prevention and treatment. This comprehensive review explores these plants' botanical diversity, traditional uses, pharmacological applications, and chemical composition. The NPSE boast a rich diversity with 138 medicinal plants across 55 families identified as traditionally and pharmacologically used against diabetes globally. Notably, the Asteraceae and Lamiaceae families are prevalent in antidiabetic applications. In vitro studies have revealed their significant inhibition of carbohydrate-metabolizing enzymes, and certain plant co-products regulate genes involved in carbohydrate metabolism and insulin secretion. In vivo trials have demonstrated antidiabetic effects, including glycaemia regulation, insulin secretion, antioxidant activity, and lipid profile modulation. Medicinal plants in NPSE exhibit various activities beyond antidiabetic, such as antioxidant, anti-inflammatory, antibacterial, anti-cancer, and more. Chemical analyses have identified over fifty compounds like phenolic acids, flavonoids, terpenoids, and polysaccharides responsible for their efficacy against diabetes. These findings underscore the potential of NPSE medicinal plants as antidiabetic candidates, urging further research to develop effective plant-based antidiabetic drugs, beverages, and supplements.

Understanding spatiotemporal patterns of COVID-19 incidence in Portugal: A functional data analysis from August 2020 to March 2022

During the SARS-CoV-2 pandemic, governments and public health authorities collected massive amounts of data on daily confirmed positive cases and incidence rates. These data sets provide relevant information to develop a scientific understanding of the pandemic's spatiotemporal dynamics. At the same time, there is a lack of comprehensive approaches to describe and classify patterns underlying the dynamics of COVID-19 incidence across regions over time. This seriously constrains the potential benefits for public health authorities to understand spatiotemporal patterns of disease incidence that would allow for better risk communication strategies and improved assessment of mitigation policies efficacy. Within this context, we propose an exploratory statistical tool that combines functional data analysis with unsupervised learning algorithms to extract meaningful information about the main spatiotemporal patterns underlying COVID-19 incidence on mainland Portugal. We focus on the timeframe spanning from August 2020 to March 2022, considering data at the municipality level. First, we describe the temporal evolution of confirmed daily COVID-19 cases by municipality as a function of time, and outline the main temporal patterns of variability using a functional principal component analysis. Then, municipalities are classified according to their spatiotemporal similarities through hierarchical clustering adapted to spatially correlated functional data. Our findings reveal disparities in disease dynamics between northern and coastal municipalities versus those in the southern and hinterland. We also distinguish effects occurring during the 2020-2021 period from those in the 2021-2022 autumn-winter seasons. The results provide proof-of-concept that the proposed approach can be used to detect the main spatiotemporal patterns of disease incidence. The novel approach expands and enhances existing exploratory tools for spatiotemporal analysis of public health data.

Chemogenetic manipulation of astrocyte activity at the synapse- a gateway to manage brain disease

Astrocytes are the major glial cell type in the central nervous system (CNS). Initially regarded as supportive cells, it is now recognized that this highly heterogeneous cell population is an indispensable modulator of brain development and function. Astrocytes secrete neuroactive molecules that regulate synapse formation and maturation. They also express hundreds of G protein-coupled receptors (GPCRs) that, once activated by neurotransmitters, trigger intracellular signalling pathways that can trigger the release of gliotransmitters which, in turn, modulate synaptic transmission and neuroplasticity. Considering this, it is not surprising that astrocytic dysfunction, leading to synaptic impairment, is consistently described as a factor in brain diseases, whether they emerge early or late in life due to genetic or environmental factors. Here, we provide an overview of the literature showing that activation of genetically engineered GPCRs, known as Designer Receptors Exclusively Activated by Designer Drugs (DREADDs), to specifically modulate astrocyte activity partially mimics endogenous signalling pathways in astrocytes and improves neuronal function and behavior in normal animals and disease models. Therefore, we propose that expressing these genetically engineered GPCRs in astrocytes could be a promising strategy to explore (new) signalling pathways which can be used to manage brain disorders. The precise molecular, functional and behavioral effects of this type of manipulation, however, differ depending on the DREADD receptor used, targeted brain region and timing of the intervention, between healthy and disease conditions. This is likely a reflection of regional and disease/disease progression-associated astrocyte heterogeneity. Therefore, a thorough investigation of the effects of such astrocyte manipulation(s) must be conducted considering the specific cellular and molecular environment characteristic of each disease and disease stage before this has therapeutic applicability.

Spatiotemporal evolution of COVID-19 in Portugal's Mainland with self-organizing maps

BACKGROUND

Self-Organizing Maps (SOM) are an unsupervised learning clustering and dimensionality reduction algorithm capable of mapping an initial complex high-dimensional data set into a low-dimensional domain, such as a two-dimensional grid of neurons. In the reduced space, the original complex patterns and their interactions can be better visualized, interpreted and understood.

METHODS

We use SOM to simultaneously couple the spatial and temporal domains of the COVID-19 evolution in the 278 municipalities of mainland Portugal during the first year of the pandemic. Temporal 14-days cumulative incidence time series along with socio-economic and demographic indicators per municipality were analyzed with SOM to identify regions of the country with similar behavior and infer the possible common origins of the incidence evolution.

RESULTS

The results show how neighbor municipalities tend to share a similar behavior of the disease, revealing the strong spatiotemporal relationship of the COVID-19 spreading beyond the administrative borders of each municipality. Additionally, we demonstrate how local socio-economic and demographic characteristics evolved as determinants of COVID-19 transmission, during the 1st wave school density per municipality was more relevant, where during 2nd wave jobs in the secondary sector and the deprivation score were more relevant.

CONCLUSIONS

The results show that SOM can be an effective tool to analysing the spatiotemporal behavior of COVID-19 and synthetize the history of the disease in mainland Portugal during the period in analysis. While SOM have been applied to diverse scientific fields, the application of SOM to study the spatiotemporal evolution of COVID-19 is still limited. This work illustrates how SOM can be used to describe the spatiotemporal behavior of epidemic events. While the example shown herein uses 14-days cumulative incidence curves, the same analysis can be performed using other relevant data such as mortality data, vaccination rates or even infection rates of other disease of infectious nature.

Evaluating Quality-of-Life, Length of Stay and Cost-Effectiveness of a Front-Door Geriatrics Program: An Exploratory Proof-of-Concept Study

BACKGROUND

The Emergency Department Interventions for Frailty (EDIFY) program was developed to deliver early geriatric specialist interventions at the Emergency Department (ED). EDIFY has been successful in reducing acute admissions among older adults.

OBJECTIVES

We aimed to examine the effectiveness of EDIFY in improving health-related quality-of-life (HRQOL) and length of stay (LOS), and evaluate EDIFY's cost-effectiveness.

DESIGN

A quasi-experiment study.

SETTING

The ED of a 1700-bed tertiary hospital.

PARTICIPANTS

Patients (≥85 years) pending acute hospital admission and screened by the EDIFY team to be potentially suitable for discharge or transfer to low-acuity care areas.

INTERVENTION

EDIFY versus standard-care.

MEASUREMENTS

Data on demographics, comorbidities, premorbid function, and frailty status were gathered. HRQOL was measured using EQ-5D-5L over 6 months. We used a crosswalk methodology to compute Singapore-specific index scores from EQ-5D-5L responses and calculated quality-adjusted life-years (QALYs) gained. LOS and bills in Singapore-dollars (SGD) before subsidy from ED attendances (including admissions, if applicable) were obtained. We estimated average programmatic EDIFY cost and performed multiple imputation (MI) for missing data. QALYs gained, LOS and cost were compared. Potential uncertainties were also examined.

RESULTS

Among 100 participants (EDIFY=43; standard-care=57), 61 provided complete data. For complete cases, there were significant QALYs gained at 3-month (coefficient=0.032, p=0.004) and overall (coefficient=0.096, p=0.002) for EDIFY, whilst treatment cost was similar between-groups. For MI, we observed only overall QALYs gained for EDIFY (coefficient=0.102, p=0.001). EDIFY reduced LOS by 17% (Incident risk ratio=0.83, p=0.015). In a deterministic sensitivity analysis, EDIFY's cost-threshold was SGD$2,500, and main conclusions were consistent in other uncertainty scenarios. Mean bills were: EDIFY=SGD$4562.70; standard-care=SGD$5530.90. EDIFY's average programmatic cost approximated SGD$469.30.

CONCLUSIONS

This exploratory proof-of-concept study found that EDIFY benefits QALYs and LOS, with equivalent cost, and is potentially cost-effective. The program has now been established as standard-care for older adults attending the ED at our center.

Modelling of Fractionated Condensation for Off-Flavours Reduction from Red Wine Fermentation Headspace

A mathematical model of fractionated condensation is proposed for predicting the recovery and fractionation of target aromas from red wine fermentation headspaces in order to remove off-flavours. The applicability of the model is assessed for two different alternative processes: fractionated condensation and vapour permeation-fractionated condensation. The aromas of the headspace of red wine fermentation are commonly lost through the fermenter venting system and are enhanced by the stripping effect of the produced CO₂. To mimic the operating conditions during the red wine fermentation, all experiments were performed at 30 °C with a red wine model solution containing relevant red wine aromas, the cosolvent ethanol at representative concentrations, and CO₂. Both studied processes allow for a good recovery of esters in the 2nd condenser, with over 80% of ethyl acetate and isoamyl acetate recovery when using vapour permeation-fractionated condensation and a recovery of 84-96% of all esters when using fractionated condensation. However, only the integrated process of vapour permeation-fractionated condensation achieves a significant decrease in the amount of ethyl phenols (off-flavours compounds) in the 1st condenser, above 50%, as expected due to the use of an organophilic membrane. The developed model was validated experimentally for the integrated process, proving to be a highly valuable tool for the prediction of aroma fractionation, aiming at the removal of off-flavours.

ESR2 expression in subcutaneous adipose tissue is related to body fat distribution in women, and knockdown impairs preadipocyte differentiation

OBJECTIVES

Estrogen signaling occurs mainly through estrogen receptor alpha (ESR1) and beta (ESR2). ESR2 expression is higher in subcutaneous adipose tissue (SAT) from postmenopausal compared to premenopausal women. The functional significance of altered ESR2 expression is not fully known. This study investigates the role of ESR2 in adipose tissue lipid and glucose metabolism.

METHODS

SAT were obtained by needle biopsies from 10 female subjects with T2D and 10 control subjects. Correlation analysis between ESR2 gene expression in SAT and markers of obesity and glucose metabolism. ESR2 knockdown was performed in preadipocytes isolated from SAT of females using CRISPR/Cas9 gene editing. In vitro differentiated knockdown adipocytes were characterized for differentiation rate, lipid storage, and glucose uptake.

RESULTS

ESR2 expression in SAT from females was negatively correlated with weight, waist-to-hip ratio, visceral adipose tissue volume, and markers of fatty acid oxidation, and positively correlated with markers related to lipid storage, and glucose transport. In SAT, ESR2 levels were found predominantly in mature adipocytes. In preadipocytes from females, ESR2 knockdown reduced preadipocyte differentiation compared to wild type cultures. This corresponded to reduced expression of markers of differentiation, lipogenesis, and lipolysis. Glucose uptake was reduced in adipocytes in knockdown cultures.

CONCLUSION

Our results indicate that ESR2 deficiency is associated with visceral adiposity and reduced subcutaneous adipocyte differentiation and lipid storage in women. High ESR2 expression, as seen after menopause, could be a contributing factor to SAT expansion. This provides insight into a possible target to promote a healthy obesity phenotype.

FC028: Characterization of Adipocyte Size and Glucose Uptake in Adipose Tissue with Focus on Different Perirenal Fat Depots

BACKGROUND AND AIMS

Previous studies have suggested that the anatomical location of adipose tissue, and the characteristics of the adipocytes regulating adipose tissue function may be of importance for normal renal function and disease.

However, in humans, the adipocyte size and metabolism of the fat depots surrounding the kidney have not been thoroughly characterized. The aim of this study was therefore to characterize adipocyte size and glucose uptake in human perirenal, renal sinus and paranephric adipose tissue.

SUBJECTS AND METHODS

A total of 25 healthy kidney donors [13 (50%) men, age 48 ± 11 years and BMI 25.7 ± 3.1 kg/m2] were included. Perirenal, renal sinus, paranephric, omental and subcutaneous adipose tissue were collected during laparoscopic unilateral nephrectomy. Adipocyte diameter, basal glucose uptake (no insulin) and insulin-stimulated glucose uptake (25 and 1000 µU/mL) were measured in isolated adipocytes from the different tissues.

RESULTS

The mean adipocyte cell diameters in the renal fat depots (perirenal, renal sinus and paranephric) were smaller than those in omental and subcutaneous tissue (mean ± sd; 69.3 ± 15.5,  65.5 ± 13.5 and 75.9 ± 16.5 versus 80.3 ± 20.5 and 85.5 ± 16.7 µm,  respectively) with adipocytes from the renal sinus fat depot having the smallest cell diameter. Detailed data are displayed in Fig. 1. There were no significant gender differences in cell size and adipocyte size from the different depots did not correlate with body mass index (BMI). Insulin resistance index (HOMA-IR) correlated positively and significantly to adipocyte size in the omental (r = 0.607; P = 0.008), perirenal (r = 0.443; P = 0.027) and paranephric (r = 0.479; P = 0.015) depots. Insulin (both with 25 and 1000 µU/mL) significantly up-regulated glucose uptake in subcutaneous (1.6 and 1.9-fold; P < 0.05), perirenal (1.7 and 2.0-fold; P < 0.01) and paranephric (1.5 and 1.6-folds; P < 0.01) adipocytes, compared with basal (no insulin) as shown in Fig. 2. Interestingly, glucose uptake per cell surface was higher in renal sinus than omental adipocytes (basal (no insulin) 1.2-fold; P < 0.001, physiological (25 µU/mL) and supraphysiological (1000 µU/mL) both 1.3-fold higher; P < 0.001) than omental adipocytes (comparison not shown).

CONCLUSION

This study in healthy kidney donors indicate differences in different fat depots surrounding the kidney that may be of importance for renal function and disease. The fat depot in the renal sinus, with the smallest adipocytes and potentially a higher glucose uptake, is of specific interest. Detailed metabolic characterization of these fat depots is ongoing.

Comparison of adipocyte diameter between the different adipose tissue depots: subcutaneous (n = 24), omental (n = 18), perirenal (n = 25), renal sinus (n = 21) and paranephric adipose tissue (n = 25); Values are mean with SEM as data were normally distributed. **P < 0.01 and ***P < 0.001.

Physiological and supraphysiological effect of insulin (25 and 1000 µU/mL) on glucose uptake compared with basal (no insulin) by cell surface in adipocytes isolated from subcutaneous (n = 6), omental (n = 3), perirenal (n = 21), renal sinus (n = 4) and paranephric (n = 18) adipose tissue depots, respectively. Values are median and interquartile range as data were not normally distributed. *P < 0.05, **P < 0.01.

Effectiveness of non-pharmacological interventions to manage anxiety in adolescents in the perioperative period: a systematic review protocol

OBJECTIVE

This review aims to evaluate the effectiveness of non-pharmacological interventions to manage anxiety in adolescents in the perioperative period.

INTRODUCTION

Adolescents undergoing surgery suffer considerable levels of anxiety and distress before surgery, which are maintained beyond the procedure. Although the benefit of non-pharmacological interventions in this area is significant, their efficacy is still under-studied.

INCLUSION CRITERIA

This review will consider studies that focus on adolescents aged 10 to 19 years, who have undergone a surgical procedure. All studies that focus on non-pharmacological interventions occurring in the perioperative period designed to reduce anxiety without restrictions on comparators, geography, or culture will be included.

METHODS

An initial limited search of PubMed and CINAHL has been undertaken and will be followed by a second search for published and unpublished studies, without limitations of publication date, in major health care-related electronic databases. Studies in English, Spanish, and Portuguese will be included. After full-text studies are retrieved, methodological quality assessment and data extraction will be performed independently by two reviewers. A narrative synthesis will accompany the results and, if possible, a meta-analysis will be performed and a Grading of Recommendations, Assessment, Development and Evaluation (GRADE) Summary of Findings presented.

SYSTEMATIC REVIEW REGISTRATION NUMBER

PROSPERO CRD42020184386.

Hedychium gardnerianum Sheph. ex Ker Gawl. from its discovery to its invasive status: a review

Hedychium gardnerianum Sheph. ex Ker Gawl. is one of the 100 world's worst invasive alien species and the research target in areas as diverse as biological control, natural fibres uses, taxonomy or the biological activity of its compounds. This review aimed to clarify the taxonomic status and the native range of H. gardnerianum and bring accuracy to the history of its introduction and escape from cultivation through the analysis of the increasing number of accessible digitalized dry specimens and grey literature. The analysis of the available information allowed to conclude that: (a) Hedychium gardnerianum is a validly published name, the authority of the name is Sheph. ex Ker Gawl., the species holotype is the illustration published along with the species name, and the Natural History Museum BM000574691 specimen collected in 1815 is the first dried specimen of H. gardnerianum; (b) This species is native to the Central and Eastern Nepal, Bhutan, Northeast India and North Myanmar; (c) The species was cultivated at Cambridge Botanical Garden since 1818 and the first known herbarium specimen collected in Europe dates back to 1821; (d) Kathmandu (Nepal) and Khasi Hills (India) specimens are considered two varieties of the same species and the BM000574691 specimen is the lectotype of H. gardnerianum var. speciosum; (e) Specimens, references, and/or pictures support that H. gardnerianum escaped from cultivation at Galicia (Spain), Azores archipelago, Madeira, Tenerife, Cuba, Jamaica, Martinique, Trinidad, Ascension, Mexico, Honduras, Brazil, South Africa, Swaziland, Zimbabwe, Réunion, Mauritius, Australia, New Zealand, Fiji, Hawaii, and Vietnam; and (f) H. gardnerianum is a serious pest in Azores, Madeira, Jamaica, Réunion, New Zealand and Hawaii and continues to expand its distribution area in South and Central America, Australia and Southern Africa. This review presents linear raw information compiled with precision, allowing the world databases updating their data but also gives the most detailed information possible to each country/region identifying new regions of concern and updating the invasiveness status in each region.

Spatially variable pesticide application in olive groves: Evaluation of potential pesticide-savings through stochastic spatial simulation algorithms

Site-specific management using spatial crown volume characterization can greatly reduce the amount of pesticides applied in agricultural treatments performed with air-assisted sprayers, while helping farmers achieve the European legislation on safe use of pesticides. Nevertheless, variable rate treatments in olive groves have received little attention. Thus, field research was conducted in a 20.6-ha traditional olive grove. Two attributes of the trees - tree crown volume (V) and tree projected area - were determined, using 67 samples for V and all trees of the field (1433) for tree projected area. Spatial continuity of both attributes was modelled with exponential variograms. To gain a measure of local uncertainty, stochastic simulation algorithms were applied. One hundred simulated images were obtained for tree projected area using direct sequential simulation. Tree projected area simulations were used to improve spatial prediction of V, more difficult and more expensive to obtain, taking advantage of the high linear correlation between both variables (r_xy = 0.72,p < 0.001). Thus, direct sequential cosimulation was employed to predict the spatial distribution of V, obtaining 100 geostatistical realizations of V. In order to estimate the potential reduction of pesticide use in the farm with variable rate treatments, two cut-off values of V were considered (50 and 100 m³_{crown volume}). Local uncertainty, understood as the probability of each tree belonging to a given crown volume interval was determined. Probability maps were further transformed to morphological maps and finally to variable prescription maps. Two scenarios with 2 and 3 management zones (MZs) were obtained. In comparison with a conventional phytosanitary application, the variable rate treatments could reduce the pesticide amounts by 21.3% with 2 MZs, and by 38% with 3 MZs. The joint use of V and tree projected area in stochastic sequential simulation algorithms has shown to be useful to determine MZs in olive groves.

Reproduction of Hypoptopoma inexspectatum (Holmberg, 1893) (Siluriformes, Loricariidae) in the Southern Pantanal Floodplain, Upper Paraguay River Basin, Brazil

This work aimed to describe the reproductive biology of Hypoptopoma inexspectatum in southern Pantanal. A total of 538 individuals were sampled and analyzed from February 2009 through January 2011 in southern Pantanal. We did not observe differences in sex-ratio, and both sexes presented positive allometric length/weight relationship (LWR). Reproduction occurs mainly from January to February. Females reached first maturation (L50) with 37.80 mm and males with 45.80 mm. Absolute fecundity is estimated in mean=177.43 (sd±127.06) oocytes and relative fecundity in 3.12 (sd±2.23) oocytes/mg. Fecundity is positively correlated with standard length (Spearman r= 0.43; p=0.013), and total spawning is a used spawning strategy for H. inexspectatum.

[Type B insulin resistance syndrome]

Type B insulin resistance syndrome (TBIRS) is a very rare autoimmune condition with polyclonal autoantibodies directed against the insulin receptor, which results in severe and refractory hyperglycemia and high mortality. Described here is a patient who, within a few months after the onset of an autoimmune type 1 diabetes, increased her insulin requirements more than 20-fold, and despite this having a considerable difficulty maintaining  her P-glucose < 40-60 mmol/L. On suspicion of TBIRS the patient was started on tapering glucocorticoids to overcome the autoimmune insulin receptor blockade, resulting in an immediate and dramatic effect. Within days insulin requirements decreased by 80-90 %, and the P-glucose stabilized around 7-8 mmol/L. The presence of antibodies to the insulin receptor was detected by immunoprecipitation and binding assays. After a 4-month remission on low maintenance dose prednisolone the patient relapsed, which required repeated plasmaphereses with temporarily remarkable effect. Mixed and transient results were seen with rituximab, mycophenolic acid and bortezomib but glycemic control has remained suboptimal. Lack of compliance and recurrent infections may have contributed to this.

Geostatistical COVID-19 infection risk maps for Portugal

The rapid spread of the SARS-CoV-2 epidemic has simultaneous time and space dynamics. This behaviour results from a complex combination of factors, including social ones, which lead to significant differences in the evolution of the spatiotemporal pattern between and within countries. Usually, spatial smoothing techniques are used to map health outcomes, and rarely uncertainty of the spatial predictions are assessed. As an alternative, we propose to apply direct block sequential simulation to model the spatial distribution of the COVID-19 infection risk in mainland Portugal. Given the daily number of infection data provided by the Portuguese Directorate-General for Health, the daily updates of infection rates are calculated by municipality and used as experimental data in the geostatistical simulation. The model considers the uncertainty/error associated with the size of each municipality's population. The calculation of daily updates of the infection risk maps results from the median model of one ensemble of 100 geostatistical realizations of daily updates of the infection risk. The ensemble of geostatistical realizations is also used to calculate the associated spatial uncertainty of the spatial prediction using the interquartile distance. The risk maps are updated daily and show the regions with greater risks of infection and the critical dynamics related to its development over time.

Type B insulin resistance syndrome in a patient with type 1 diabetes

SUMMARY

Type B insulin resistance syndrome (TBIRS) is a very rare autoimmune disorder with polyclonal autoantibodies against the insulin receptor, resulting in severe and refractory hyperglycemia. Described here is a patient who within a few months after the onset of autoimmune type 1 diabetes increased her insulin requirements more than 20-fold; despite this she had considerable difficulty maintaining a plasma glucose value of <40-60 mmol/L (720-1100 mg/dL). On suspicion of TBIRS, the patient was started on tapering dose of glucocorticoids to overcome the autoimmune insulin receptor blockade, resulting in an immediate and pronounced effect. Within days, insulin requirements decreased by 80-90% and plasma glucose stabilized around 7-8 mmol/L (126-144 mg/dL). The presence of antibodies to the insulin receptor was detected by immunoprecipitation and binding assays. After a 4-month remission on low maintenance dose prednisolone, the patient relapsed, which required repeated plasmaphereses and immune column treatments with temporarily remarkable effect. Mixed and transient results were seen with rituximab, mycophenolic acid and bortezomib, but the glycemic status remained suboptimal. Lack of compliance and recurrent infections may have contributed to this.

LEARNING POINTS

Type B insulin resistance syndrome (TBIRS) is a very rare autoimmune disorder with acquired polyclonal autoantibodies against the insulin receptor, resulting in severe and refractory hyperglycemia. We describe here a young patient in whom, a few months after the onset of a regular autoimmune diabetes, insulin requirements in a short time increased more than 20-fold, but despite this, the plasma glucose level could be kept at <40-60 mmol/L only with considerable difficulty. Did this patient have TBIRS? On suspicion of TBIRS, the patient was started on tapering glucocorticoids to overcome the autoimmune insulin receptor blockade, resulting in an immediate and pronounced effect; within days insulin requirements decreased by 80-90% and plasma glucose stabilized around 7-8 mmol/L. The presence of antibodies to the insulin receptor was detected by immunoprecipitation and binding assays. After a 4-month remission on low maintenance dose prednisolone, the patient relapsed, which required repeated plasmaphereses with temporarily remarkable effect. TBIRS should be considered in diabetic patients whose glycemia and/or insulin requirements are inexplicably and dramatically increased.

Validation of automated whole-body analysis of metabolic and morphological parameters from an integrated FDG-PET/MRI acquisition

Automated quantification of tissue morphology and tracer uptake in PET/MR images could streamline the analysis compared to traditional manual methods. To validate a single atlas image segmentation approach for automated assessment of tissue volume, fat content (FF) and glucose uptake (GU) from whole-body [18F]FDG-PET/MR images. Twelve subjects underwent whole-body [18F]FDG-PET/MRI during hyperinsulinemic-euglycemic clamp. Automated analysis of tissue volumes, FF and GU were achieved using image registration to a single atlas image with reference segmentations of 18 volume of interests (VOIs). Manual segmentations by an experienced radiologist were used as reference. Quantification accuracy was assessed with Dice scores, group comparisons and correlations. VOI Dice scores ranged from 0.93 to 0.32. Muscles, brain, VAT and liver showed the highest scores. Pancreas, large and small intestines demonstrated lower segmentation accuracy and poor correlations. Estimated tissue volumes differed significantly in 8 cases. Tissue FFs were often slightly but significantly overestimated. Satisfactory agreements were observed in most tissue GUs. Automated tissue identification and characterization using a single atlas segmentation performs well compared to manual segmentation in most tissues and will be valuable in future studies. In certain tissues, alternative quantification methods or improvements to the current approach is needed.

Caretta caretta nesting activity on Akumal Beaches, Mexico

Mexico has made substantial contributions to marine turtle protection and conservation, especially since 1990. Several conservation projects entail monitoring efforts to recover nesting territories for marine turtles. The Sea Turtle Protection Program of Akumal, in the Mexican state of Quintana Roo, was created in 1993 and was developed by the Akumal Ecological Center. This paper provides the nesting ecology parameters for Caretta caretta over a protection period of 24 years (1995-2018). A well-defined nesting peak was observed in June, with a nesting success rate of 75.2 ± 23.0%. Nesting females showed a mean curved carapace length of 99.0 ± 5.6  cm. The mean clutch size was 108.6 ± 24.6 eggs, with variation among years. The mean incubation period was 57.2 ± 6.2 days. The hatching and emergence success rates were 87.2 ± 16.9% and 78.8 ± 24.4%, respectively. For the 926 tagged females that returned, the remigration interval peaked at 726 days, with a 12-day inter-nesting period. The results show not only the recovery of the nesting population over time but also a decrease in female size; we postulate that this decrease is due to the recruitment of young females, which has been increasingly pronounced since 2010. Hence, the Akumal rookery plays an important role in its corresponding regional management unit (Atlantic Northwest).

Measuring and mapping the effectiveness of the European Air Quality Directive in reducing N and S deposition at the ecosystem level

To protect human health and the environment (namely ecosystems), international air quality protocols and guidelines, like the Gothenburg protocol (1999) and the 2001 EU Air Quality Directive (NECD), conveyed national emission ceilings for atmospheric pollutants (Directive 2001/81/EC), including the reduction of sulfur (S) and nitrogen (N) emissions by 2010. However, to what degree this expected reduction in emissions had reflections at the ecosystem level (i.e. pollutant levels reaching and impacting ecosystems and their organisms) remains unknown. Here, we used lichens as ecological indicators, together with reported air and precipitation pollutant concentrations, to determine and map the consequences of the S and N atmospheric emission's reduction, during the implementation of the 2001 Directive (in 2002 and 2011), due primarily to the industrial-sector. The study area is a mixed-land-use industrialized Mediterranean agroforest ecosystem, in southwest Europe. The reduction of S emissions (2002-2011) was reflected at the ecosystem level, as the same S-declining trend was observed in atmospheric measurement stations and lichens alike (-70%), indicating that most S deposited to the ecosystem had an industrial origin. However, this was not the case for N with a slight N-reduction near industrial facilities, but mostly N-deposition in lichens increased in areas dominated by agricultural land-uses. Taken together, these results highlight the importance of going beyond emissions estimation and modeling, to assess the success of the implementation of the NECD in lowering pollutant accumulation in living organisms and their environment. This can only be achieved by measuring pollutant deposition at the ecosystem level (e.g. living organisms). By doing so, we were able to show that the 2001 NECD was successful in reducing S concentrations from Industry, whereas N remains a challenge. Despite the small reduction in N-emissions, deposition into ecosystems did not reflect these changes as agriculture and transport sectors must reduce NH₃ and NO_x emissions.

Modelling local uncertainty in relations between birth weight and air quality within an urban area: combining geographically weighted regression with geostatistical simulation

In this study, we combine known methods to present a new approach to assess local distributions of estimated parameters measuring associations between air quality and birth weight in the urban area of Sines (Portugal). To model exposure and capture short-distance variations in air quality, we use a Regression Kriging estimator combining air quality point data with land use auxiliary data. To assess uncertainty of exposure, the Kriging estimator is incorporated in a sequential Gaussian simulation algorithm (sGs) providing a set of simulated exposure maps with similar spatial structural dependence and statistical properties of observed data. Following the completion of the simulation runs, we fit a geographically weighted generalized linear model (GWGLM) for each mother's place of residence, using observed health data and simulated exposure data, and repeat this procedure for each simulated map. Once the fit of GWGLM with all exposure maps is finished, we take the distribution of local estimated parameters measuring associations between exposure and birth weight, thus providing a measure of uncertainty in the local estimates. Results reveal that the distribution of local parameters did not vary substantially. Combining both methods (GWGLM and sGs), however, we are able to incorporate local uncertainty on the estimated associations providing an additional tool for analysis of the impacts of place in health.

Using nitrogen concentration and isotopic composition in lichens to spatially assess the relative contribution of atmospheric nitrogen sources in complex landscapes

Reactive nitrogen (Nr) is an important driver of global change, causing alterations in ecosystem biodiversity and functionality. Environmental assessments require monitoring the emission and deposition of both the amount and types of Nr. This is especially important in heterogeneous landscapes, as different land-cover types emit particular forms of Nr to the atmosphere, which can impact ecosystems distinctively. Such assessments require high spatial resolution maps that also integrate temporal variations, and can only be feasibly achieved by using ecological indicators. Our aim was to rank land-cover types according to the amount and form of emitted atmospheric Nr in a complex landscape with multiple sources of N. To do so, we measured and mapped nitrogen concentration and isotopic composition in lichen thalli, which we then related to land-cover data. Results suggested that, at the landscape scale, intensive agriculture and urban areas were the most important sources of Nr to the atmosphere. Additionally, the ocean greatly influences Nr in land, by providing air with low Nr concentration and a unique isotopic composition. These results have important consequences for managing air pollution at the regional level, as they provide critical information for modeling Nr emission and deposition across regional as well as continental scales.

Software for improved field surveys of nesting marine turtles

Field data are still recorded on paper in many worldwide beach surveys of nesting marine turtles. The data must be subsequently transferred into an electronic database, and this can introduce errors in the dataset. To minimize such errors, the "Turtles" software was developed and piloted to record field data by one software user accompanying one Tortuguero in Akumal beaches, Quintana Roo, Mexico, from June 1^st to July 31^st during the night patrols. Comparisons were made between exported data from the software with the paper forms entered into a database (henceforth traditional). Preliminary assessment indicated that the software user tended to record a greater amount of metrics (i.e., an average of 18.3 fields ± 5.4 sd vs. 8.6 fields ± 2.1 sd recorded by the traditional method). The traditional method introduce three types of "errors" into a dataset: missing values in relevant fields (40.1%), different answers for the same value (9.8%), and inconsistent data (0.9%). Only 5.8% of these (missing values) were found with the software methodology. Although only tested by a single user, the software may suggest increased efficacy and warrants further examination to accurately assess the merit of replacing traditional methods of data recording for beach monitoring programmes.

Traffic represents the main source of pollution in small Mediterranean urban areas as seen by lichen functional groups

The land-use type (residential, green areas, and traffic) within relatively small Mediterranean urban areas determines significant changes on lichen diversity, considering species richness and functional groups related to different ecological factors. Those areas with larger volume of traffic hold lower species diversity, in terms of species richness and lichen diversity value (LDV). Traffic areas also affect the composition of the lichen community, which is evidenced by sensitive species. The abundance of species of lichens tolerant to low levels of eutrophication diminishes in traffic areas; oppositely, those areas show a higher abundance of species of lichens tolerating high levels of eutrophication. On the other hand, residential and green areas have an opposite pattern, mainly with species highly tolerant to eutrophication being less abundant than low or moderate ones. The characteristics of tree bark do not seem to affect excessively on lichen composition; however, tree species shows some effect that should be considered in further studies.

Neighbourhood Determinants of Caries Experience in Preschool Children: A Multilevel Study

OBJECTIVES

To investigate the association between neighbourhood factors and decayed, missing, and filled teeth (dmft) index among preschool children.

METHODS

The sample of this cross-sectional study comprised 1,110 children (0-5 years old) clustered in 16 official neighbourhoods of Canoas city, southern Brazil. Multilevel binomial models were used to estimate the association of contextual variables at neighbourhood level (Human Development Index, average income, and public primary health care units) with two oral health outcomes: decayed teeth (dt) and missing or filled teeth (mft), after adjusting for individual variables (gender, age, maternal education, equivalent household income logarithm, household, and point of care).

RESULTS

Overall, 24.9% of the sample had dental caries experience (dmft >0), and 92.3% of the dmft was untreated caries. There was no statistical significant association (p > 0.05) of contextual characteristics with the decay component. The teeth of children living in richer areas had 2.87 (95% CI: 1.05-7.86) times more chances of being treated (mft component). Variance attributed to neighbourhood level was estimated as 5.9% (p < 0.01) and 4.1% (p = 0.17) for dt and mft, respectively, in adjusted models.

CONCLUSIONS

Intra-urban areas seem homogeneous, with small variability between neighbourhoods, having no contextual effect on untreated dental caries (dt). Contextual variables may influence treatment access (mft) through the use of dental services in preschool children.

Feline leishmaniosis in Portugal: 3 cases (year 2014)

Leishmaniosis caused by Leishmania infantum is a zoonotic disease endemic in many countries of America, Asia and Europe, including Portugal. Dogs are the major reservoir of L. infantum, but domestic cats may also be infected. Three clinical cases of feline leishmaniosis are described, with ocular clinical signs as the only manifestation of the disease. A case had bilateral anterior uveitis and a granulomatous conjunctivitis, another one presented keratitis and the third case had a nodular blepharitis. All the affected cats had high serum titres of antibodies to L. infantum, while polymerase chain reaction results were positive in two of the cats. Although all cats in the present study improved after treatment with meglumine antimoniate and/or allopurinol, one of them died 6months later apparently due to a systemic L. infantum infection. The prevalence of disease may be underestimated in cats, because leishmaniosis is often not considered in the differential diagnosis of feline diseases. Feline leishmaniosis should be suspected in cats with ocular clinical signs and in those living in or traveling to areas where the zoonosis is endemic.

Transvenous removal of cardiac implantable electronic device leads

INTRODUCTION AND OBJECTIVE

The number and complexity of cardiac implantable electronic devices (CIEDs) have increased, as has the number of related complications, often leading to removal of the implanted system. The aim of this study was to characterize transvenous explantation/extraction of CIED leads in a reference center.

METHODS

This was a descriptive observational study of patients consecutively admitted from January 2009 to May 2014 for transvenous lead extraction.

RESULTS

The sample consisted of 109 patients, with a mean age of 64.6±16.62 years, 73.1% male. The main indication for lead extraction was CIED infection. The mean time from first implantation to lead removal was 5.6±4.89 years. Blood cultures were positive in 32.8% of cases and 29% of patients had vegetations on echocardiography. A total of 228 cardiac leads were removed, of which 58.8% were ventricular, 32.4% atrial and 8.8% coronary sinus. Complete clinical success was achieved in 97.2% of cases, while procedural success was complete in 93.4% and partial in 5.3%. The complications reported were three cases of significant pocket hematoma, one of subclavian vein thrombosis and three of cardiac tamponade, effectively treated by pericardiocentesis.

CONCLUSIONS

Transvenous explantion or extraction of CIED leads was highly effective. A high level of experience is an essential factor in the success and safety of the procedure.

Disentangling natural and anthropogenic sources of atmospheric sulfur in an industrial region using biomonitors

Despite reductions in atmospheric sulfur (S) concentrations due to abatement policies in some countries, modeling the dispersion of this pollutant and disentangling anthropogenic sources from natural ones is still of great concern. Lichens have been used as biomonitors of the impacts of S for over 40 years, but their potential as source-tracers of specific sources, including natural ones, remains unexplored. In fact, few attempts have been made to try to distinguish and spatially model different sources of S using lichens. We have measured S concentrations and isotopic values in lichens within an industrial coastal region where different sources of S, natural and anthropogenic, interplay. We detected a prevailing influence of natural sea-originated S that mixed with anthropogenic sources of S. We were then able to disentangle the sources of S, by removing the ocean influence on S isotopic values, enabling us to model the impact of different anthropogenic sources on S deposition and highlighting the potential use of lichens to evaluate the weight of different types of anthropogenic sources.

A case report of improved metabolic control after conversion from everolimus to cyclosporin A: role of adipose tissue mechanisms?

BACKGROUND

New-onset diabetes after transplantation is associated with an increase in risk of graft failure, cardiovascular disease, and mortality. Therefore, it compromises the overall beneficial outcome of organ transplantation.

CASE REPORT

A patient with new-onset diabetes after renal transplantation showed glucose and lipid metabolism improvements after switching immunosuppressant from everolimus to cyclosporin A. A subcutaneous adipose tissue biopsy displayed changes in gene and protein expression that could contribute to the clinical improvement of hyperglycemia and dyslipidemia.

Short and long term in vivo effects of Cyclosporine A and Sirolimus on genes and proteins involved in lipid metabolism in Wistar rats

OBJECTIVE

Cyclosporine A (CsA) and sirolimus (SRL) are immunosuppressive agents (IA) associated with new onset diabetes after transplantation and dyslipidemia. We aim to evaluate the molecular effects of CsA (5mg/kg/day) and SRL (1mg/kg/day) treatment for 3 and 9weeks on lipid metabolism, in Wistar rats.

MATERIALS/METHODS

Lipolysis was evaluated in isolated adipocytes, while triglycerides (TG) and non-esterified fatty acid (NEFA) were measured in serum. Gene and protein expression involved in lipid metabolism was assessed in adipose tissue and liver.

RESULTS

CsA and SRL treatments of rats for 3 and 9weeks increased isoproterenol-stimulated lipolysis by 5-9 fold and 4-6 fold in isolated adipocytes, respectively. While CsA increased adipocyte weight and diameter, as well as NEFA and TG levels in circulation after 9weeks, SRL treatment caused ectopic deposition of TG in the liver after 3weeks. Moreover, ACC1 and FAS protein expression was increased after 3weeks (>100%, p<0.01), while HSL was increased after 9weeks of CsA treatment. On the other hand, SRL decreased the expression of lipogenic genes, including ACC1 (50%, p<0.05), lipin1 (25%, p<0.05), PPAR-γ (42%, p<0.05) and SCD1 (80%, p<0.001) in adipose tissue, after 3weeks of treatment.

CONCLUSION

The effects of both IAs on expression of lipolytic and lipogenic genes suggest that these agents influence lipid metabolism, thus contributing to the dyslipidemia observed during immunosuppressive therapy.

Tools for determining critical levels of atmospheric ammonia under the influence of multiple disturbances

Critical levels (CLEs) of atmospheric ammonia based on biodiversity changes have been mostly calculated using small-scale single-source approaches, to avoid interference by other factors, which also influence biodiversity. Thus, it is questionable whether these CLEs are valid at larger spatial scales, in a multi- disturbances context. To test so, we sampled lichen diversity and ammonia at 80 sites across a region with a complex land-cover including industrial and urban areas. At a regional scale, confounding factors such as industrial pollutants prevailed, masking the CLEs. We propose and use a new tool to calculate CLEs by stratifying ammonia concentrations into classes, and focusing on the highest diversity values. Based on the significant correlations between ammonia and biodiversity, we found the CLE of ammonia for Mediterranean evergreen woodlands to be 0.69 μg m(-3), below the previously accepted value of 1.9 μg m(-3), and below the currently accepted pan-European CLE of 1.0 μg m(-3).

Differences between men and women in the regulation of adipose 11β-HSD1 and in its association with adiposity and insulin resistance

This study explored sex differences in 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) activity and gene expression in isolated adipocytes and adipose tissue (AT), obtained via subcutaneous biopsies from non-diabetic subjects [58 M, 64 F; age 48.3 ± 15.3 years, body mass index (BMI) 27.2 ± 3.9 kg/m²]. Relationships with adiposity and insulin resistance (IR) were addressed. Males exhibited higher 11β-HSD1 activity in adipocytes than females, but there was no such difference for AT. In both men and women, adipocyte 11β-HSD1 activity correlated positively with BMI, waist circumference, % body fat, adipocyte size and with serum glucose, triglycerides and low-density lipoprotein:high-density lipoprotein (LDL:HDL) ratio. Positive correlations with insulin, HOMA-IR and haemoglobin A1c (HbA1c) and a negative correlation with HDL-cholesterol were significant only in males. Conversely, 11β-HSD1 activity in AT correlated with several markers of IR and adiposity in females but not in males, but the opposite pattern was found with respect to 11β-HSD1 mRNA expression. This study suggests that there are sex differences in 11β-HSD1 regulation and in its associations with markers of obesity and IR.

Effects of cyclosporine and sirolimus on insulin-stimulated glucose transport and glucose tolerance in a rat model

Cyclosporine (CsA) and sirolimus (SRL) have been associated with undesirable side effects, including posttransplantation diabetes and hyperlipidemia, but the molecular mechanisms underlying these effects remain to be elucidated. Animal studies focusing on clinically relevant doses are advised. This study sought to compare the metabolic effects on isolated rat adipocytes treated with either CsA or SRL ex vivo and after long-term in vivo treatment in Wistar rats. We assessed the ex vivo effects of CsA (0.5-30 μmol/L) and SRL (1-250 μmol/L) on insulin-stimulated (14)C-glucose uptake in epididymal adipocytes (n = 6-9). In parallel, rats (n = 12) were treated with either vehicle, CsA (5 mg/kg/d) or SRL (1 mg/kg/d) for either 3 or 9 weeks. At the end of the treatment, glucose tolerance test (GTT) and insulin-stimulated (14)C-glucose uptake as well as biochemical parameters were analyzed. A significant reduction in the insulin-stimulated glucose uptake over basal was observed among isolated adipocytes, whether exposed ex vivo or in vivo to CsA or SRL treatment. Furthermore, the SRL group showed significantly lighter fat pads and smaller adipocytes at 3 weeks with a smaller gain in body weight throughout the study compared with either the vehicle or CsA cohorts. Glucose intolerance was observed after a GTT, at the end of the treatment with either drug. Additionally, at 9 weeks serum triglycerides were increased by CsA compared with vehicle or SRL treatment. Interestingly, although SRL-treated animals presented higher fed and fasted insulin levels compared with either group, suggesting insulin resistance, the CsA group presented lower fed and fasted insulin values, suggesting a defect in insulin secretion at 9 weeks. These results suggested that either ex vivo treatment of fat cells or in vivo treatment of rats with CsA or SRL impaired insulin-stimulated glucose uptake by adipocytes. Both drugs caused glucose intolerance, which altogether could be responsible for the development of posttransplantation diabetes.

Measurement of quality of recovery using the QoR-40: a quantitative systematic review

BACKGROUND

Several rating scales have been developed to measure quality of recovery after surgery and anaesthesia, but the most extensively used is the QoR-40, a 40-item questionnaire that provides a global score and subscores across five dimensions: patient support, comfort, emotions, physical independence, and pain. It has been evaluated in a variety of settings, but its overall psychometric properties (validity, reliability, ease of use, and interpretation) and clinical utility are uncertain.

METHODS

We undertook a quantitative systematic review of studies evaluating psychometric properties of the QoR-40. Data were combined in meta-analyses using random effects models. This resulted in a total sample of 3459 patients from 17 studies originating in nine countries.

RESULTS

We confirmed content, construct, and convergent [pooled r=0.58, 95% confidence interval (CI): 0.51-0.65] validity. Reliability was confirmed by excellent intraclass correlation (pooled α=0.91, 95% CI: 0.88-0.93), test-retest reliability (pooled r=0.90, 95% CI: 0.86-0.92), and inter-rater reliability (intraclass correlation=0.86). The clinical utility of the QoR-40 instrument was supported by high patient recruitment into evaluation studies (97%), and an excellent completion and return rate (97%). The mean time to complete the QoR-40 was 5.1 (95% CI: 4.4-5.7) min.

CONCLUSIONS

The QoR-40 is a widely used and extensively validated measure of quality of recovery. The QoR-40 is a suitable measure of postoperative quality of recovery in a range of clinical and research situations.

Assessing human exposure to polycyclic aromatic hydrocarbons (PAH) in a petrochemical region utilizing data from environmental biomonitors

Polycyclic aromatic hydrocarbons (PAH) are toxic compounds that have been classified by the International Agency for Research on Cancer as probable or possible human carcinogens. Human exposure to PAH is usually assessed by considering data from a single air monitoring station as being representative of a large region; however, air pollution levels change on small spatial scales and thus also affect environmental exposure. The use of environmental biomonitors is a useful tool to assess the levels of PAH with high spatial resolution. The aims of this study were to (1) assess human exposure to PAH in a petrochemical region in Portugal, integrating data from environmental biomonitors (lichens), air, and soil in a regional area, and (2) determine the health risks associated with exposure to PAH with high spatial resolution. Bearing this in mind, benzo[a]pyrene (BaP) equivalent concentrations in samples of soil, air, and lichens collected in the study region were used to assess human exposure through different pathways, including inhalation of air and soil particles, ingestion of soil, and dermal contact with soil. Human health risk was calculated through the Incremental Lifetime Cancer Risk (ILCR). BaP equivalent concentrations found in the region ranged from 6.9 to 46.05 ng BaPeq/g in lichens, from 16.45 to 162.02 ng BaPeq/g in soils, and from 0.02 to 0.16 ng BaPeq/m³ in air, indicative of high variability in this regional area. Human exposure to PAH varied between 976 and 42,877 ng BaPeq/d. When considering all exposure pathways, ILCR values were between 10⁻⁴ and 10⁻³. Considering only inhalation, ILCR values were between 10⁻⁶ and 10⁻⁵. The main risk seemed to arise from soil (either ingestion or inhalation of resuspended soil particles). The high spatial resolution of our environmental data allowed for detection of critical exposure levels at unexpected sites. Our results identified important areas where health studies on local populations need to be focused, and where environmental levels of PAH need to be monitored over time in order to protect human health.

Lichens as an integrating tool for monitoring PAH atmospheric deposition: a comparison with soil, air and pine needles

The aim of this study was to validate lichens as biomonitors of PAH atmospheric deposition; for that, an inter-comparison between the PAH profile and concentrations intercepted in lichens with those of air, soil and pine needles was performed. The study was conducted in a petro-industrial area and the results showed that PAH profiles in lichens were similar to those of the air and pine needles, but completely different from those of soils. Lichens accumulated higher PAH concentrations when compared to the other environmental compartments and its concentrations were significantly and linearly correlated with concentrations of PAHs in soil; we showed that a translation of the lichen PAHs concentrations into regulatory standards is possible, fulfilling one of the most important requirements of using lichens as biomonitors. With lichens we were then able to characterize the air PAHs profile of urban, petro-industrial and background areas.

Effects of decavanadate and insulin enhancing vanadium compounds on glucose uptake in isolated rat adipocytes

The effects of different vanadium compounds namely pyridine-2,6-dicarboxylatedioxovanadium(V) (V5-dipic), bis(maltolato) oxovanadium(IV) (BMOV) and amavadine, and oligovanadates namely metavanadate and decavanadate were analysed on basal and insulin stimulated glucose uptake in rat adipocytes. Decavanadate (50 microM), manifest a higher increases (6-fold) on glucose uptake compared with basal, followed by BMOV (1 mM) and metavanadate (1 mM) solutions (3-fold) whereas V5 dipic and amavadine had no effect. Decavanadate (100 microM) also shows the highest insulin like activity when compared with the others compounds studied. In the presence of insulin (10 nM), only decavanadate increases (50%) the glucose uptake when compared with insulin stimulated glucose uptake whereas BMOV and metavanadate, had no effect and V5 dipic and amavadine prevent the stimulation to about half of the basal value. Decavanadate is also able to reduce or eradicate the suppressor effect caused by dexamethasone on glucose uptake at the level of the adipocytes. Altogether, vanadium compounds and oligovanadates with several structures and coordination spheres reveal different effects on glucose uptake in rat primary adipocytes.

Spatial modeling of PAHs in lichens for fingerprinting of multisource atmospheric pollution

PAHs are toxic compounds emitted by several anthropogenic sources, which have a great impact on human health. We show, for the first time, how spatial models based on PAHs intercepted by lichens can be used for fingerprinting multisource atmospheric pollution in a regional area. Urban-industrial areas showed the highest atmospheric deposition of PAHs followed by urban > industrial > agricultural > forest Multivariate analysis of lichen data showed, for the first time, a clear distinction between various sources of PAHs in the same area: urban are dominated by 4-ring PAHs, forest by 3-ring PAHs, and industrial by 5- and 6-ring PAHs or by 2-ring PAHs (petrogenic or pyrogenic, respectively). Heavy metals were also used for supporting the fingerprinting of PAH sources, reinforcing the industrial origin of 5- and 6-ring PAHs and revealing their particular nature. The spatial structure of the models for different PAHs seems to be dependent on the following factors: size and hydrophilic character of different PAHs, type of emission sources (point or nonpoint), and dispersion associated with particulates of different sizes. Based on the long-term integration of PAHs in lichens, these spatial models will significantly improve our knowledge on the impact of PAH chronic-exposure to humans and ecosystems.

A whole sample toxicity assessment to evaluate the sub-lethal toxicity of water and sediment elutriates from a lake exposed to diffuse pollution

The impact of diffuse pollution in aquatic systems is of great concern due to the difficult to measure and regulate it. As part of an ecological risk assessment (ERA), this study aims to use a whole sample toxicity assessment to evaluate the toxicity of water and sediment from Lake Vela, a lake that has been exposed to diffuse pollution. In this way, standard (algae: Pseudokirchneriella subcapitata; cladoceran: Daphnia magna) and local species (algae: Aphanizomenon flos-aquae; cladoceran: Daphnia longispina) were exposed to surface water, and sediment elutriates were collected seasonally from two sites at Lake Vela: one near the east bank (ES), surrounded by agricultural lands; and the other near the west bank (WS), surrounded by a forest. The results confirmed the seasonal contamination of both environmental compartments by pesticides, including organochlorine pesticides, and the presence of high concentrations of nutrients. Although both sites were contaminated, higher levels of pesticides and nutrients were detected in ES, particularly in the sediments. Bioassays showed that water samples (100% concentration) collected in summer and autumn significantly affected the growth rate of P. subcapitata, which could be attributed to the presence of pesticides. Likewise, they revealed an apparent toxicity of elutriates for P. subcapitata and for both daphnids, in summer and autumn. In fact, although pesticides were not detected in elutriates, high levels of un-ionized ammonia were recorded, which is considered highly toxic to aquatic life. By comparing the several species, P. subcapitata was revealed to be the most sensitive one, followed by the daphnids, and then by A. flos-aquae. Results obtained in this study underlined the importance of whole samples toxicity assessment for characterizing the ecological effects of complex mixtures from diffuse inputs, in the ERA processes.

Causes of change in nitrophytic and oligotrophic lichen species in a Mediterranean climate: impact of land cover and atmospheric pollutants

With the aim of determining the main drivers of changes in nitrophytic and oligotrophic macro-lichen communities in an industrial region with a Mediterranean climate, we considered both land-cover types and atmospheric pollutants. We determined the relation between the abundance of nitrophytic and oligotrophic species with environmental factors considering the distance of influence of land-cover types. The results showed that oligotrophic species decreased in the proximity of artificial areas, barren land and agricultural areas, associated with higher concentrations of NO2 and Zn, and Ti, probably dust of industrial and agricultural origin. Nitrophytic species were positively related to all the mentioned land-cover types, and with higher concentrations of Fe and N. Magnesium, probably from ocean aerosols, was negatively related to oligotrophic species and positively to nitrophytic.

Impact of neighbourhood land-cover in epiphytic lichen diversity: analysis of multiple factors working at different spatial scales

The objective of this work was to determine the impact of neighbourhood land-cover in epiphytic lichen diversity. We used geostatistics to analyse the spatial structure of lichen-indicators (number of lichen species and Lichen Diversity Value) and correlate them to land-cover considering different distances from the observed data. The results showed that lichen diversity was influenced by different environmental factors that act in the same territory but impact lichens at different distances from the source. The differences in the distance of influence of the several land-cover types seem to be related to the size of pollutants/particles that predominantly are dispersed by each land-cover type. We also showed that a local scale of analysis gives a deeper insight into the understanding of lichen richness and abundance in the region. This work highlighted the importance of a multiple spatial scale of analysis to deeply interpret the relation between lichen diversity and the underling environmental factors.

Phytoassessment of acid mine drainage: Lemna gibba bioassay and diatom community structure

An integrated multilevel phytoassessment of an acid mine drainage (AMD, pH range 3.3-6.8) in southern Portugal was performed. A 7-day phytotoxicity bioassay with the duckweed Lemna gibba (chlorosis, necrosis, growth) was carried out, both in the laboratory and in situ, combined with an analysis of the resident epilithic diatom community. The toxicity test was performed with water from the AMD gradient, an unpolluted river control and acidified control water, in order to discriminate potential pH-effects from combined pH- and metal-effects. Diatom communities discriminated well among the sites (alkalophilic species versus halobiontic, acidobiontic and acidophilic species), showing inter-site differences to be larger than intra-site seasonal variations. In L. gibba exposed to AMD, necrosis and growth inhibition were higher in situ compared to the laboratory experiments. L. gibba was more sensitive to AMD than to acidified water. Already after 4 days, growth rate inhibition in L. gibba proved to be a reliable indicator of AMD-stress. Ecotoxicological thresholds obtained with L. gibba corresponded with those obtained previously with animals of intermediate tolerance to AMD. The results were summarised in a multimetric index.

Fucus spp. as a mercury contamination bioindicator in costal areas (Northwestern Portugal)

Mercury has been considered as one of the most important pollutants in coastal and estuarine areas. Efforts have been made to detect, as early as possible, the effects of this and other metals in several species. Macroalgae, particularly Fucus spp., have been widely used as biomonitors of metal pollution. In this study, three Fucus species (F. spiralis, F. vesiculosus and F. ceranoides) were collected from several sampling sites in Portugal. The concentrations of mercury were determined in three structural parts (holdfast, stipe and receptacles). Two different techniques were used to determine mercury concentrations. Almost all mercury concentrations (in sediments and in water) were below national and international standards. Mercury concentration in the specimens (0.012-0.061 microg g(-1) for receptacles, 0.028-0.221 microg g(-1) for stipe and 0.029-0.287 microg g(-1) for holdfast) was always higher that those obtained for the sediment (0.001-0.112 microg g(-1)). With few exceptions the contrary was found for receptacles. In general, a good agreement between concentrations of mercury in sediment and Fucus was found. The results indicate that Fucus accumulate mercury and may be a suitable species for use in risk assessment for coast and estuarine areas, by providing valuable information regarding the levels of mercury that will be available for the consumers of Fucus spp.

The contribution of environmental biomonitoring with lichens to assess human exposure to dioxins

The contribution of environmental biomonitoring with lichens to assess human exposure to dioxins was the main purpose of this work. For that, polychlorinated dibenzofurans (PCDD/F) were measured in 66 lichen sampling points. The obtained information significantly improved the basic knowledge on the environmental exposure to dioxins through distinction between effective control areas from areas with moderate atmospheric deposition. It allowed the integration of PCDD/F atmospheric deposition for much longer periods, allowing to relate low levels with long-term chronic effects on health. Thus, the production of high-resolution data on environmental exposure essential to perform reliable environmental health studies was possible. It was argued that PCDD/F in lichens may be used as spatial estimators of the potential risk of inhalation by the population present in the area. An example of the application of this data to select control and exposed areas for environmental health studies was presented.